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Mirada Casebook

Mirada Casebook. Case study 1: Colorectal. Case 1: 18FDG PET/CT Colorectal Restaging. Indication: T3 N1 R0 sigmoid colectomy August 2009 CT demonstrated solitary segment VI/VII liver metastasis PET/CT 18FDG Whole Body: skull base to upper thigh. Findings Blood glucose = 5.6 mmol /l

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Mirada Casebook

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  1. Mirada Casebook Case study 1: Colorectal

  2. Case 1: 18FDG PET/CT Colorectal Restaging • Indication: T3 N1 R0 sigmoid colectomy August 2009 • CT demonstrated solitary segment VI/VII liver metastasis • PET/CT 18FDG Whole Body: skull base to upper thigh. • Findings • Blood glucose = 5.6 mmol/l • There are two definite foci of increased uptake in keeping with hepatic metastases • F1: posteriorly in segment VI/VII (1.4 cm SUV max = 6.8) and • F2: segment Iva (1cm SUV max = 5.1) • No evidence of residual or recurrent disease at the primary tumour site. No FDG avid locoregional or distant lymph-nodes. No other PET evidence of malignancy.

  3. How Casebook was used in this example • The bookmarks in the presentation relate to the findings in the corresponding scan. During a presentation these may be discussed while showing the finding in Casebook. • In the sample bookmarks we have shown some of the features of Casebook including: • Bookmark 1: Shows only the base layer, illustrates the lesion in CT only • Bookmark 2: Shows the same view with the PET overlay on, and the cross-hairs off • Bookmark 3: Shows the same lesion, adjusting window, level, zoom and pan • Bookmark 4: Demonstrates a change of colormap, view layout and overlay transparency • Bookmark 5:Showing the second lesion in all views and hiding the overlay text • Bookmark 6:Changes to the coronal view and adjusts the base window and level • Bookmark 7: Switches to axial view, hides the cross-hairs and adjusts the overlay transparency • All the navigation and image display adjustments are available during presentation. • For example, if a question is asked for which a bookmark has not been prepared, you can navigate or adjust the display appropriately. • Another advantage of Casebook is that you can adjust the window and level or fusion transparency to compensate for poor projection.

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