When do you requst a liver biopsy when trying to dertmine if a lesion is cancerous or not ?
A year ago I was diagnosed with Hairy Cell Leukemia in the hip area which I was told would need to be monitored for improvements with PETscans. My first PET Scan showed high metabolic activity in the hip (as was expected) and the liver (4.2 SUV). My oncologist was suprised by the liver reading and ordered another PetScan. This PetScan showed the same results. I then had my chemo and the expectation was the chemo would knock everything out (hip and liver).
I just had my follow-up PetScan (this time it was a PET-CT scan) which showed no abnormal metabolic activity in the hip. The liver still shows metabolic activity (6.2 SUV). I was hoping that my oncologist would want to request a liver biopsy, but he wants to wait a few months. Any opinions ? Whats the downside of requesting a biopsy ? I have put my latest PET-CT scan results below.
Findings:
Multiple low-attenuation lesions were seen in the liver on a previous CT scan, but NOT on the current PET study. There is only one f
I do need to clarify that I have not had a personal follow-up with my oncologist. I have been trading e-mails back and forth with his office/fellow. Based on the e-mails betwenn his office and myself I interpreted the next course of action to wait a few months and potentially get another blow of chemo. I probably need to set-up a personal visit to his office to discuss the results.
The PET-CT scan shows the lesion at 1.7 cm, isn't that pretty small ?
Note the 2/28 PET showed a 3.2 SUV
The 5/17 PET/CT showed a 6.3 (note the 5/17 scan was a combination PET/CT scan.
- medicgvd
I would guess they are thinking that the downside would be the risk of uncontrolled bleeding given the state of your liver. They could do a transjugular biopsy and that would limit the risk but the procedure is fairly invasive. (and it hurts like crap no matter what they say) I've had one done and it was not a picnic. The biopsy might not shed enough light to warrant the risk of bleeding via the traditional route or the inconvenience of the transjugular catheter.
Hope that helps. Good luck!
- peggyprobus
It sounds as if your last PET scan was really good news. Of course the decision to do a biopsy will have to be decided by your doctor. I know it's very difficult not to feel like any pain or symptom is a sign of recurrence but it sounds like your onocologist is doing a really good job and is keeping your best interests in mind. I sure hope you beat this thing - keep the faith.
- james c
a 6.2 suv, is he/she crazy! normal in the liver is 2.5-3.0. A biopsy is not needed because it is cancer! I would get a second opinion and make sure they are using a PET/CT and not just PET.
I would get a second opinion!
Good luck,
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