Chapter 4: To g-string? Or not to g-string? 3/22/17

This is not really the question, but I bet I got your attention.
The real question is: To g-scan? Or not to g-scan? 
Yesterday 3/21/17 was a notably good day.
Don had an echocardiogram to check out his heart to make sure all was well. Apparently one challenge to this disease is that the hormone (serotonin) that is released by the NETs (neuroendocrine tumors) can damage the heart. According to the scan, Don’s heart is looking good! Hooray!
Also on yesterday, Don had a PET/CT scan of his chest. This was to take a closer look, to see if anymore NETs were spotted, which would tell us if it has spread beyond the liver. The most common place for these tumors to spread after the liver is to the lungs. The scan was clean! Chest is looking good! Yahoo!
But back to the question: To g-scan? Or not to g-scan? What the heck do I mean by this?
I am learning that on the cutting edge of radiologic medicine is nuclear medicine. Wow. Who knew? (I’ll tell you who knew – the people who pay attention to this stuff. The people in Cancerland. That’s who.) So beyond normal x-rays are CT scans and MRIs, which you have probably heard of. And maybe even had performed on you. The next step after that is nuclear medicine imaging. (Or something like this.) NMI uses small amounts of radioactive materials called radiotracers that are typically injected into the bloodstream, inhaled or swallowed. The radiotracer travels through the area being examined and gives off energy in the form of gamma rays which are detected by a special camera and a computer to create images of the inside of your body. Nuclear medicine imaging provides unique information that often cannot be obtained using other imaging procedures and offers the potential to identify disease in its earliest stages. This is the cutting edge of Cancerland research and has become very important to us.
So the current NMI scan is the octreoscan. It’s not available in Greensboro, but is available at Duke and UNC. Many NET patients get these scans, usually more than once. And then there is this other NMI scan — the gallium scan, or the ga-68 scan — that is the newest technology around. It was FDA approved in 2016 and the best at “seeing” NETs. (NETs can be missed by a standard CT scan; and even missed by an octreoscan.) NET patients and advocates we have networked with online suggest that all NET patients should get one of these g-scans. However, it’s so new, that it is not available in many places yet. It is not yet in Greensboro, and I’m still trying to see if it’s available anywhere in NC. A road trip might be in our future…stay tuned.
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Reference info, FYI:
X-ray or radiography uses a very small dose of ionizing radiation to produce pictures of the body’s internal structures. X-rays are the oldest and most frequently used form of medical imaging. They are often used to help diagnosed fractured bones, look for injury or infection and to locate foreign objects in soft tissue. Some x-ray exams may use an iodine-based contrast material or barium to help improve the visibility of specific organs, blood vessels, tissues or bone.
Computed tomography (CT) is a diagnostic imaging test used to create detailed images of internal organs, bones, soft tissue and blood vessels. The cross-sectional images generated during a CT scan can be reformatted in multiple planes, and can even generate three-dimensional images which can be viewed on a computer monitor, printed on film or transferred to electronic media. CT scanning is often the best method for detecting many different cancers since the images allow your doctor to confirm the presence of a tumor and determine its size and location. CT is fast, painless, noninvasive and accurate. In emergency cases, it can reveal internal injuries and bleeding quickly enough to help save lives.
Magnetic resonance imaging (MRI) uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of the body’s internal structures that are clearer, more detailed and more likely in some instances to identify and accurately characterize disease than other imaging methods. It is used to evaluate the body for a variety of conditions, including tumors and diseases of the liver, heart, and bowel.
MRIrandom
Pictured: enhanced CT scan through abdomen (not Don’s scan); thank you random google search! $50 for the first person who can spot the liver in this picture!
Footnote: https://www.radiologyinfo.org/
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