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SUV Uptake Question

Forums General Melanoma Community SUV Uptake Question

  • Post
    jennunicorn
    Participant

      Had another PET/CT scan today. Good news: the lung nodules are shrinking, so no mel there!

      But, there is a lymph node in my left armpit that grew 2cm (measures 2.5×1.0cm) and lit up (it never lit up before). SUV uptake is 7.7. Never had uptake that high before. Not even really famliar with what a "high uptake" is. So, question for the veterans that know this stuff… is that high? I'm not too worried about it, maybe I'll need a biopsy, who knows. Tumor board will review next Friday and I'll find out what they suggest. There's also a new left groin lymph node that grew and lit up but that uptake is only 4.2… still more than I've had before, but, compared with 7.7 it doesn't seem as concerning. I know PET scans can have false positives and I also know that Ipi can be creating more reactive lymph nodes, so, that's why I'm not really freaking out over this stuff. Also, when did freaking out ever help me? I'll tell you: never. ๐Ÿ™‚

      As always, sending lots of positive vibes to all of you, thinking about everyone going through their own struggles and roller coaster rides with mel.

       

    Viewing 23 reply threads
    • Replies
        BrianP
        Participant

          Hey Jenn,

          I'm not the expert but I'm going through something similar.  I'll share what a couple experts have shared with me.  My latest scan showed a new 1.5 cm and 2.0 cm node with a SUV of 5.5 and 6.6.  Dr. Weber thought this was in the gray area for concern.  He said below 3 or 4 he would recommend just wait and rescan, 5 to 8 or 9 he would recommend a biopsy, and above 10 he would think that was pretty sure to be new disease.  Now take that with a grain of salt because I've been off treatment for a year.  Someone still on treatment or closer to stopping treatment could certainly have more immunotherapy induced PET SUV uptake.  Dr. Salama at Duke told me they've had instances where the SUV kept increasing and became so high they decided to resect only to find out it was not melanoma. 

          Hang in there.  Your not freaking out strategy sounds good. 

          Brian

          BrianP
          Participant

            Hey Jenn,

            I'm not the expert but I'm going through something similar.  I'll share what a couple experts have shared with me.  My latest scan showed a new 1.5 cm and 2.0 cm node with a SUV of 5.5 and 6.6.  Dr. Weber thought this was in the gray area for concern.  He said below 3 or 4 he would recommend just wait and rescan, 5 to 8 or 9 he would recommend a biopsy, and above 10 he would think that was pretty sure to be new disease.  Now take that with a grain of salt because I've been off treatment for a year.  Someone still on treatment or closer to stopping treatment could certainly have more immunotherapy induced PET SUV uptake.  Dr. Salama at Duke told me they've had instances where the SUV kept increasing and became so high they decided to resect only to find out it was not melanoma. 

            Hang in there.  Your not freaking out strategy sounds good. 

            Brian

            BrianP
            Participant

              Hey Jenn,

              I'm not the expert but I'm going through something similar.  I'll share what a couple experts have shared with me.  My latest scan showed a new 1.5 cm and 2.0 cm node with a SUV of 5.5 and 6.6.  Dr. Weber thought this was in the gray area for concern.  He said below 3 or 4 he would recommend just wait and rescan, 5 to 8 or 9 he would recommend a biopsy, and above 10 he would think that was pretty sure to be new disease.  Now take that with a grain of salt because I've been off treatment for a year.  Someone still on treatment or closer to stopping treatment could certainly have more immunotherapy induced PET SUV uptake.  Dr. Salama at Duke told me they've had instances where the SUV kept increasing and became so high they decided to resect only to find out it was not melanoma. 

              Hang in there.  Your not freaking out strategy sounds good. 

              Brian

                jennunicorn
                Participant

                  I feel like I have heard something similar to that. My oncologist called this scan "interesting" but is not super concerned right now. She'll wait to hear what tumor board says, she said it's likely they'll recommend a biopsy.

                  Thanks Brian!

                  jennunicorn
                  Participant

                    I feel like I have heard something similar to that. My oncologist called this scan "interesting" but is not super concerned right now. She'll wait to hear what tumor board says, she said it's likely they'll recommend a biopsy.

                    Thanks Brian!

                    jennunicorn
                    Participant

                      I feel like I have heard something similar to that. My oncologist called this scan "interesting" but is not super concerned right now. She'll wait to hear what tumor board says, she said it's likely they'll recommend a biopsy.

                      Thanks Brian!

                    Kim K
                    Participant

                      At most institutions an SUV of 3.5 or higher is concerning for mel mets, especially if it continues to rise on a second set of scans done during the same session.  That being said, there is false positive and negatives as well as other benign causes and CT and other diagnostics as needed to make an interpretation.  You can Google scholarly articles on SUV interpretation.  If you have progression in size and increased SUV between scans though, I would be worried.

                      I would be asking what is the next move(s) to deal with this thing.  Hopefully nothing to worry about, but I researched the same topic several years ago.

                      Kim K
                      Participant

                        At most institutions an SUV of 3.5 or higher is concerning for mel mets, especially if it continues to rise on a second set of scans done during the same session.  That being said, there is false positive and negatives as well as other benign causes and CT and other diagnostics as needed to make an interpretation.  You can Google scholarly articles on SUV interpretation.  If you have progression in size and increased SUV between scans though, I would be worried.

                        I would be asking what is the next move(s) to deal with this thing.  Hopefully nothing to worry about, but I researched the same topic several years ago.

                          jennunicorn
                          Participant

                            It definitely stands out to me, since any uptake I've had in lymph nodes before have been under 3 and it is noted in the CT portion of the scan that it grew 2cm. Most likely I'll be told to get a biopsy. 

                            Thanks for your help!

                            jennunicorn
                            Participant

                              It definitely stands out to me, since any uptake I've had in lymph nodes before have been under 3 and it is noted in the CT portion of the scan that it grew 2cm. Most likely I'll be told to get a biopsy. 

                              Thanks for your help!

                              jennunicorn
                              Participant

                                It definitely stands out to me, since any uptake I've had in lymph nodes before have been under 3 and it is noted in the CT portion of the scan that it grew 2cm. Most likely I'll be told to get a biopsy. 

                                Thanks for your help!

                              Kim K
                              Participant

                                At most institutions an SUV of 3.5 or higher is concerning for mel mets, especially if it continues to rise on a second set of scans done during the same session.  That being said, there is false positive and negatives as well as other benign causes and CT and other diagnostics as needed to make an interpretation.  You can Google scholarly articles on SUV interpretation.  If you have progression in size and increased SUV between scans though, I would be worried.

                                I would be asking what is the next move(s) to deal with this thing.  Hopefully nothing to worry about, but I researched the same topic several years ago.

                                momof4boys
                                Participant
                                  I had new lymph nodes in my chest light up recently with an suv of 5.9. Had s biopsy and it came back as overactive lymph tissue, nothing to worry about. I also have taken ipi, including all maintenance doses. You probably will get a biopsy, tumor board will probably play safe but it doesn’t necessarily mean its mel!
                                    jennunicorn
                                    Participant

                                      That's why I am not freaking out. I had the same thing done on a groin lymph node back in March, no mel, just reactive. So, that's what I am figuring for this one too. Thank you!

                                      jennunicorn
                                      Participant

                                        That's why I am not freaking out. I had the same thing done on a groin lymph node back in March, no mel, just reactive. So, that's what I am figuring for this one too. Thank you!

                                        jennunicorn
                                        Participant

                                          That's why I am not freaking out. I had the same thing done on a groin lymph node back in March, no mel, just reactive. So, that's what I am figuring for this one too. Thank you!

                                        momof4boys
                                        Participant
                                          I had new lymph nodes in my chest light up recently with an suv of 5.9. Had s biopsy and it came back as overactive lymph tissue, nothing to worry about. I also have taken ipi, including all maintenance doses. You probably will get a biopsy, tumor board will probably play safe but it doesn’t necessarily mean its mel!
                                          momof4boys
                                          Participant
                                            I had new lymph nodes in my chest light up recently with an suv of 5.9. Had s biopsy and it came back as overactive lymph tissue, nothing to worry about. I also have taken ipi, including all maintenance doses. You probably will get a biopsy, tumor board will probably play safe but it doesn’t necessarily mean its mel!
                                            stotes
                                            Participant

                                              Jenn – This is a very interesting topic and something that I just started trying to research.  I just had a PET/CT scan done and there is an area on my right gluteus maximus muscle that is "suspicious for melanoma" and has an SUV of 3.6 and also there were some "prominent left axillary nodes with no uptake".  These are both new findings since my last scan.  I had this scan done because I had a "bump" that grew on my right upper back while taking Ipi.  I had a excisional biopsy done and it tested negative for melanoma.  Two months later it grew back and I had it removed again and this time it was positive for melanoma.  I have taken three doses of Ipi at this time.  It's all so confusing and hard to understand.  Everyone has a different opinion even the melanoma specialists themselves (my doc is listed as a melanoma specialist and has consulted with one of the "top" specialists also).  Glad to have found this topic.  Hope your results are good and I am impressed with your positive attitude.  I am working on trying not to stress about all of this but it has been a struggle.  Best of luck!  Christal

                                              stotes
                                              Participant

                                                Jenn – This is a very interesting topic and something that I just started trying to research.  I just had a PET/CT scan done and there is an area on my right gluteus maximus muscle that is "suspicious for melanoma" and has an SUV of 3.6 and also there were some "prominent left axillary nodes with no uptake".  These are both new findings since my last scan.  I had this scan done because I had a "bump" that grew on my right upper back while taking Ipi.  I had a excisional biopsy done and it tested negative for melanoma.  Two months later it grew back and I had it removed again and this time it was positive for melanoma.  I have taken three doses of Ipi at this time.  It's all so confusing and hard to understand.  Everyone has a different opinion even the melanoma specialists themselves (my doc is listed as a melanoma specialist and has consulted with one of the "top" specialists also).  Glad to have found this topic.  Hope your results are good and I am impressed with your positive attitude.  I am working on trying not to stress about all of this but it has been a struggle.  Best of luck!  Christal

                                                stotes
                                                Participant

                                                  Jenn – This is a very interesting topic and something that I just started trying to research.  I just had a PET/CT scan done and there is an area on my right gluteus maximus muscle that is "suspicious for melanoma" and has an SUV of 3.6 and also there were some "prominent left axillary nodes with no uptake".  These are both new findings since my last scan.  I had this scan done because I had a "bump" that grew on my right upper back while taking Ipi.  I had a excisional biopsy done and it tested negative for melanoma.  Two months later it grew back and I had it removed again and this time it was positive for melanoma.  I have taken three doses of Ipi at this time.  It's all so confusing and hard to understand.  Everyone has a different opinion even the melanoma specialists themselves (my doc is listed as a melanoma specialist and has consulted with one of the "top" specialists also).  Glad to have found this topic.  Hope your results are good and I am impressed with your positive attitude.  I am working on trying not to stress about all of this but it has been a struggle.  Best of luck!  Christal

                                                    jennunicorn
                                                    Participant

                                                      Exactly why I call it a roller coaster… news can change from one scan to the next, from one biopsy to the next, ups and downs and twists and turns… it's a crazy ride. 

                                                      Thank you, best of luck to you as well!

                                                      jennunicorn
                                                      Participant

                                                        Exactly why I call it a roller coaster… news can change from one scan to the next, from one biopsy to the next, ups and downs and twists and turns… it's a crazy ride. 

                                                        Thank you, best of luck to you as well!

                                                        jennunicorn
                                                        Participant

                                                          Exactly why I call it a roller coaster… news can change from one scan to the next, from one biopsy to the next, ups and downs and twists and turns… it's a crazy ride. 

                                                          Thank you, best of luck to you as well!

                                                        liberty04281
                                                        Participant
                                                          I am saying from my experience, you will need biopsy. Needle biopsy is not accurate sometimes, maybe you will need surgical biopsy. It happened to me twice. Needle biopsy of lymph node was negative, and surgical biopsy showed there was melanoma.
                                                          Good Luck!
                                                          liberty04281
                                                          Participant
                                                            I am saying from my experience, you will need biopsy. Needle biopsy is not accurate sometimes, maybe you will need surgical biopsy. It happened to me twice. Needle biopsy of lymph node was negative, and surgical biopsy showed there was melanoma.
                                                            Good Luck!
                                                            liberty04281
                                                            Participant
                                                              I am saying from my experience, you will need biopsy. Needle biopsy is not accurate sometimes, maybe you will need surgical biopsy. It happened to me twice. Needle biopsy of lymph node was negative, and surgical biopsy showed there was melanoma.
                                                              Good Luck!
                                                                jennunicorn
                                                                Participant

                                                                  Yep, that's what I assume will happen too. Had a biopsy on a lymph node that lit up back in March, it was negative, still shows up on the scan but has not changed in size or uptake since then, so it's just reactive. Hopefully this is the same, but who knows.

                                                                  jennunicorn
                                                                  Participant

                                                                    Yep, that's what I assume will happen too. Had a biopsy on a lymph node that lit up back in March, it was negative, still shows up on the scan but has not changed in size or uptake since then, so it's just reactive. Hopefully this is the same, but who knows.

                                                                    jennunicorn
                                                                    Participant

                                                                      Yep, that's what I assume will happen too. Had a biopsy on a lymph node that lit up back in March, it was negative, still shows up on the scan but has not changed in size or uptake since then, so it's just reactive. Hopefully this is the same, but who knows.

                                                                    keepthefaith11
                                                                    Participant
                                                                      Jenn, just wanted you to know I am thining of you and keeping fingers crossed this is nothing. IPI can make nodes do some crazy things for sure.

                                                                      My dad has has a node show up on tests as well. Docs are not worried as of now saying his body scan is “99% good”.

                                                                      Annie

                                                                      keepthefaith11
                                                                      Participant
                                                                        Jenn, just wanted you to know I am thining of you and keeping fingers crossed this is nothing. IPI can make nodes do some crazy things for sure.

                                                                        My dad has has a node show up on tests as well. Docs are not worried as of now saying his body scan is “99% good”.

                                                                        Annie

                                                                        keepthefaith11
                                                                        Participant
                                                                          Jenn, just wanted you to know I am thining of you and keeping fingers crossed this is nothing. IPI can make nodes do some crazy things for sure.

                                                                          My dad has has a node show up on tests as well. Docs are not worried as of now saying his body scan is “99% good”.

                                                                          Annie

                                                                            jennunicorn
                                                                            Participant

                                                                              Thank you Annie. Always keeping good thoughts for you and your dad, hope he's doing well.

                                                                              jennunicorn
                                                                              Participant

                                                                                Thank you Annie. Always keeping good thoughts for you and your dad, hope he's doing well.

                                                                                jennunicorn
                                                                                Participant

                                                                                  Thank you Annie. Always keeping good thoughts for you and your dad, hope he's doing well.

                                                                                jade1111
                                                                                Participant

                                                                                  Jenn.. Fingers crossed its just some reactive lymoh nodes.. Interesting that its all in the lymph and that it has happened before. Hopefully its just because your lymph nodes are just so fantastically strong and pumping :0) Wishing you all the best!!!

                                                                                  jade1111
                                                                                  Participant

                                                                                    Jenn.. Fingers crossed its just some reactive lymoh nodes.. Interesting that its all in the lymph and that it has happened before. Hopefully its just because your lymph nodes are just so fantastically strong and pumping :0) Wishing you all the best!!!

                                                                                    jade1111
                                                                                    Participant

                                                                                      Jenn.. Fingers crossed its just some reactive lymoh nodes.. Interesting that its all in the lymph and that it has happened before. Hopefully its just because your lymph nodes are just so fantastically strong and pumping :0) Wishing you all the best!!!

                                                                                        jennunicorn
                                                                                        Participant

                                                                                          That's what I am focusing on right now, super active lymph nodes and nothing serious! Thank you! Hope your mom is doing well ๐Ÿ™‚

                                                                                          jennunicorn
                                                                                          Participant

                                                                                            That's what I am focusing on right now, super active lymph nodes and nothing serious! Thank you! Hope your mom is doing well ๐Ÿ™‚

                                                                                            jennunicorn
                                                                                            Participant

                                                                                              That's what I am focusing on right now, super active lymph nodes and nothing serious! Thank you! Hope your mom is doing well ๐Ÿ™‚

                                                                                            jennunicorn
                                                                                            Participant

                                                                                              I will be getting a biopsy of the armpit lymph node as well as the newly enlarged groin lymph node. Fingers crossed!

                                                                                              jennunicorn
                                                                                              Participant

                                                                                                I will be getting a biopsy of the armpit lymph node as well as the newly enlarged groin lymph node. Fingers crossed!

                                                                                                jennunicorn
                                                                                                Participant

                                                                                                  I will be getting a biopsy of the armpit lymph node as well as the newly enlarged groin lymph node. Fingers crossed!

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