Here's What Ruined Our Day Yesterday

In spite of what these pictures mean, I'm delighted to be able to post them.  It warms the inner geek in me that I've achieved what the average 11-year old can do anymore.

These pictures are the part of my PET scan that have caused me, Leslye and my doctors so much consternation the last couple of weeks.  Here's how you view them:  Pretend I'm lying on my back in front of you, with my feet closest to you.  You're at a vantage point that will allow you to look directly into my nostrils (sorry) and the underside of my chin(s).  My chin is pointing to the top of the picture, the back of my head is at the bottom.

The picture below is PET image of my soft tissue that has taken up the radioactive tracer.  Any decent Wikipedia article will tell you how a PET scan works, here it's important only to know that bright spots mean that lots of tracer has been absorbed.  Things that absorb tracer are hungry things like brains, livers and tumors.

Doesn't my chin and jaw line look like a shmoo from behind?

Notice the brighter fuzziness just underneath the outline of my chin and jaw; these are soft tissues that have accumulated the radioactive tracer.  I actually have no idea of what it represents, save that it's normal tissue that didn't bother my doctor.  This constellation of cotton balls is normal enough except for the one lone cotton ball above the group at about the 1:00 position, closest to my chin.  During my FNA this cotton ball was the target of the needle wielding doctor.

The picture below is the same PET picture, but overlaid with a CT scan which in this case is designed to pick up harder materials like bones.Here, the bright spots are a combination of tracer uptake and bones.

Now it looks like Dumbledore from the front, reading
a book or playing with a Slinky.

That stray cotton ball signals danger in at least a three of ways.  For one, it's hungry in a way that lymph nodes shouldn't be.  Second, it's out there all by it's lonesome, not at all where a doctor would expect it to be.  Third, there's only one of them.  Most organisms including the human body exhibit bilateral symmetry, which for we biology dropouts means that if you folded us in half along a line, both sides would match up.  In the human body that line runs down the center of your nose down and across your belly button down to the ground.

Bilateral symmetry is very important to doctors because anything not symmetrical is usually trouble.  If there had been another cotton ball about the same size at about 11:00, my doctor may not have worried as much but the fact that there was a hungry something, in an unexpected place, without a mirror image sibling, was cause for concern.

I've always been a fan of non-invasive technology -- anything that helps me avoid pain gets my vote.  Before PET and MRI and the like, doctors were pretty much limited to x-rays and "exploratory surgery". (when's the last time you heard that term?); now a lot of diagnostic work can be done by electrons, neutrinos and magic.  It's ironic that non-invasive technology can lead to invasive surgery.