Dr. KEN-LIAO LIU 劉耿僚: PITFALLS & MODIFICATION S of FDG PET-CT IN HEAD & NECK ONCOLOGY
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Nov. 12 2011, presented in the 3rd Chinese Otorhinolaryngology Head & Neck Surgery Conference. by Dr. KEN-LIAO LIU.
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Dr. KEN-LIAO LIU 劉耿僚 Pitfalls & Modifications of FDG PET-CT in Head & Neck...
1. The document discusses common pitfalls of 18F-FDG PET/CT in head and neck oncology such as inflammation, infection, and partial volume averaging effects.
2. It provides modifications to avoid pitfalls including using a neck collar, keeping the patient quiet and warm, massaging salivary glands, and having head and neck surgeons interpret scans.
3. Proper patient preparation before PET/CT and being aware of common pitfalls are emphasized.
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A 19-year-old Thai male presented to the emergency room after his motorcycle was hit by a car. He reported left knee pain for 30 minutes. On examination, he had a 4x6cm laceration wound on his left knee with exposed bone and active bleeding. Imaging showed an open left patellar fracture. He was diagnosed with an open left patellar fracture and treated empirically with antibiotics. He underwent debridement and tension band wiring in the operating room.
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The document summarizes an orthopedic case of a child who fell from a table and injured his left arm. On physical examination, the child's left elbow was swollen and deformed with limited range of motion due to pain. X-rays revealed a complete transverse fracture at the supracondylar region of the left humerus with total posterior-medial displacement, classified as a Gartland Type III injury. The child underwent closed reduction and percutaneous pinning of the fractured elbow. Post-operatively, the child will need elevation, pain control, range of motion exercises, and pin removal after 3-4 weeks once the fracture has healed. Complications of this type of injury can include nerve damage,
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- X-rays showed a closed fracture of the left supracondylar humerus, classified as a Gartland type II.
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*Notify surgeon/Reg n/a n/a n/a
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2400 n/a n/a
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(circle) Top/Bottom/Partial denture n/a n/a n/a n/a
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Bloods n/a
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UR NUMBER 075486
Chelsea Bassett
Joelle Latham
Lisa Leanard
P
E
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P
E
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A
T
IV
E
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E
C
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IS
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7
1
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Chelsea bassett
Joelle Latham
Lisa Leonard
Signature:
Signature:
Signature:
Post- Operative check performed by:
Xray/Scans:
Patient reception check performed by:
Given and signed
Given and signed
Pre-Operative check performed by:
Medical Certificate
Follow up Appointments
Observations Checked
Discharge SummaryGraduated compression stockings insitu
(Circle) N/A / with Patient / With Doctor
VTE Prevention Anticoagulant
Investigations: FBC updated
Check/Wound/Drain tube
POST OP ONLY
Epidural Test Dose
Post Op Orders
Glasses
Hearing aids
Posthetic devices
Pacemaker insitu:
Seen by technician
Pre Op Prep: Skin Prep (Betadine)
Bariatric: (>120kg) - Notify Theatre
(obtain Hover mat prior to transfer to OT)
Cytotoxic Drugs Within 48 hours
Weight Recorded:
Anaes. Record
Fasting time: Food
Fluid(Document time)
Own teeth:
Pre-medication Ordered
Ordered
IV Therapy IV bung flushed
IV orders written
Clip
Bowel Prep
Identification Labels: Min of 20
Infectious State: Please state:
Theatre notified
History: (circle) Old New
Jewellery: (circle) Taped / Removed
Make-up/Nail Polish: Removed
Underwear: (circle) Disposable / Own
Female Sanitary Products:
NB:Please remove tampons Pad in situ
Personal items with patient:
Contact lenses
Procedure on consent form corresponds with
Theatre List
* Do not allow pt to leave holding bay
Side and site of surgery:
Not Marked
Allergies:
Wrist band
Patient Identifcation (check against
Notify surgeon/registrar Not completed
Consent form:
Admission form: Wrist band
Leg band
Patient/rep signature
Doctors signature
Comments: (e.g. Alerts, manual handling issues, Infections, Bariatric skin integ.)
PRE AND POST OPERATIVE CHECKLIST YES P NO O Not Applicable N/A
5/03/2018
DOCTOR John Smith
DATE OF BIRTH
ROBERTS
Darren
25 Happy Street
CAIRNS 4860
23/11/1968
SURNAME
FIRST NAME
ADDRESS
SIMULATED HOSPITAL
Name ROBERTS, Darren Lab ID
UR 075486 Request Date 04/03/2018
Age/Sex 50 years, Male Reported Date 05/03/2018
Test Normal Range Result
Na+ mmol/L 139
K+ mmol/L 4.5
CL- mmol/L 100
Bicarb mmol/L 25
Urea mmol/L 3.5
Creatinine mmol/L 65
Glucose mmol/L 5
Ca++ mmol/L 2.5
Mg++ mmol/L 0.78
CRP mg/L 0.2
Serum Fe µmmol/L 20
Transferrin µmmol/L 45
21- 29
3.0 - 8.0
14 - 32
40 - 260
0 - 5
Laboratory Report
2100045678
Biochemistry Results
2.25 - 2.65
.
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Tonsillectomy is the surgical removal of the palatine tonsils. It is indicated for recurrent throat infections, tonsillitis causing medical issues, or enlarged tonsils obstructing breathing.
Pre-operative assessment involves evaluating the patient's medical history, examining the throat, and in some cases checking coagulation or doing a sleep study. Certain conditions like bleeding disorders or Down syndrome require special pre-operative management.
The surgery involves using various techniques like dissection and snare to separate the tonsils from surrounding tissue and remove them. Post-operative care focuses on pain management, diet, hygiene and watching for potential complications like bleeding or infection. Newer techniques aim to reduce morbidity through less invasive procedures
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Date PRE POST PRE POSTna na na na .docx
Date PRE POST PRE POST
n/a n/a
n/a n/a
n/a n/a
n/a n/a
n/a
n/a n/a
Marked
*Notify surgeon/Reg n/a n/a n/a
n/a n/a
n/a n/a n/a
n/a n/a n/a
2400 n/a n/a
2400 n/a n/a
n/a n/a
(circle) Top/Bottom/Partial denture n/a n/a n/a n/a
n/a n/a n/a n/a
n/a n/a
Pre-Operative Antibiotics: n/a n/a
n/a n/a n/a n/a
n/a
Bloods n/a
ECG n/a
n/a
n/a n/a
n/a
UR NUMBER 075486
Chelsea Bassett
Joelle Latham
Lisa Leanard
P
E
R
I-O
P
E
R
A
T
IV
E
C
H
E
C
K
L
IS
T
M
R
7
1
A
Chelsea bassett
Joelle Latham
Lisa Leonard
Signature:
Signature:
Signature:
Post- Operative check performed by:
Xray/Scans:
Patient reception check performed by:
Given and signed
Given and signed
Pre-Operative check performed by:
Medical Certificate
Follow up Appointments
Observations Checked
Discharge SummaryGraduated compression stockings insitu
(Circle) N/A / with Patient / With Doctor
VTE Prevention Anticoagulant
Investigations: FBC updated
Check/Wound/Drain tube
POST OP ONLY
Epidural Test Dose
Post Op Orders
Glasses
Hearing aids
Posthetic devices
Pacemaker insitu:
Seen by technician
Pre Op Prep: Skin Prep (Betadine)
Bariatric: (>120kg) - Notify Theatre
(obtain Hover mat prior to transfer to OT)
Cytotoxic Drugs Within 48 hours
Weight Recorded:
Anaes. Record
Fasting time: Food
Fluid(Document time)
Own teeth:
Pre-medication Ordered
Ordered
IV Therapy IV bung flushed
IV orders written
Clip
Bowel Prep
Identification Labels: Min of 20
Infectious State: Please state:
Theatre notified
History: (circle) Old New
Jewellery: (circle) Taped / Removed
Make-up/Nail Polish: Removed
Underwear: (circle) Disposable / Own
Female Sanitary Products:
NB:Please remove tampons Pad in situ
Personal items with patient:
Contact lenses
Procedure on consent form corresponds with
Theatre List
* Do not allow pt to leave holding bay
Side and site of surgery:
Not Marked
Allergies:
Wrist band
Patient Identifcation (check against
Notify surgeon/registrar Not completed
Consent form:
Admission form: Wrist band
Leg band
Patient/rep signature
Doctors signature
Comments: (e.g. Alerts, manual handling issues, Infections, Bariatric skin integ.)
PRE AND POST OPERATIVE CHECKLIST YES P NO O Not Applicable N/A
5/03/2018
DOCTOR John Smith
DATE OF BIRTH
ROBERTS
Darren
25 Happy Street
CAIRNS 4860
23/11/1968
SURNAME
FIRST NAME
ADDRESS
SIMULATED HOSPITAL
Name ROBERTS, Darren Lab ID
UR 075486 Request Date 04/03/2018
Age/Sex 50 years, Male Reported Date 05/03/2018
Test Normal Range Result
Na+ mmol/L 139
K+ mmol/L 4.5
CL- mmol/L 100
Bicarb mmol/L 25
Urea mmol/L 3.5
Creatinine mmol/L 65
Glucose mmol/L 5
Ca++ mmol/L 2.5
Mg++ mmol/L 0.78
CRP mg/L 0.2
Serum Fe µmmol/L 20
Transferrin µmmol/L 45
21- 29
3.0 - 8.0
14 - 32
40 - 260
0 - 5
Laboratory Report
2100045678
Biochemistry Results
2.25 - 2.65
.
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- 2. Case 1: Tongue carcinoma
- 3. Clean Neck
- 5. Post OP F/U
- 9. Post OP 3 months
- 10. Case 2: R ’ t supra-clavicular masses
- 14. Case 3: NPC s/p R/T
- 15. Post R/T 2 years
- 18. F/U: negative !
- 19. Case 4: Epiglottis ca.
- 20. Case 4: Epiglottis ca.
- 24. Case 5: Right buccal ca.
- 25. Pre-op
- 27. Post-OP (PMMCF) & R/T
- 28. Post-op & R/T 3 months
- 30. Post-op F/U
- 31. Case 6: Right Retromolar ca.
- 32. Winter
- 33. Summer
- 34. Summer
- 35. Case 7-1: NPC (CT: c T 1 N 1 )
- 36. Post R/T 1.5 years
- 39. Case 7-2: L ’ t Vocal Cord Paralysis with Unknown Cause.
- 45. Bone invasion ?
- 46. Tongue depressor
- 47. Tongue depressor
- 48. Tongue depressor
- 49. NSAIDs (Hypopharyngeal ca post total laryngectomy)
- 50. Mapping of the Tumor by Surgeons is absolutely necessary !!
Editor's Notes
- 3 months, R ’ t noted other mass