After the initial diagnosis, one of the most important tests we went through was the F-18 FDG Whole Body PET/CT scan.

At that time, we knew there was a suspicious finding in the lung, but we still did not fully understand how far the disease had progressed. The PET/CT was the test that helped us see the bigger picture.

The report showed a hypermetabolic mass in the left upper lobe of the lung, measuring approximately 3.1 × 2.6 cm.

The wording in the report was:

“Suspicious for lung malignancy.”

This meant that the activity seen in the lung was highly suspicious for lung cancer.

But the scan also revealed more information.

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The Possibility of Spread Beyond the Lung

The PET/CT showed increased FDG activity in several lymph nodes, including:

• Mediastinal lymph nodes (inside the chest)
• Left supraclavicular lymph node (above the collarbone)

These findings suggested that the cancer may have spread beyond the original lung lesion.

The scan also showed several areas in the bones with increased FDG uptake.

The report described:

“Multiple FDG avid lytic bone lesions, suspicious for metastases.”

Reading those words was difficult.

It meant that the doctors were concerned that the cancer may have reached areas such as the bones.

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The Brain Finding

The PET/CT also mentioned an abnormal area in the left posterior parietal region of the brain, corresponding with previous MRI findings.

The report stated that this was suspicious for metastasis.

However, we learned that MRI is usually a more accurate test for evaluating brain lesions, so the MRI results became another important piece of the puzzle.

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Some Good News From the Scan

Although the findings were concerning, there were also areas where no suspicious activity was found.

The scan did not show clear evidence of:

• Liver metastasis
• Adrenal gland involvement
• Abdominal lymph node involvement
• Significant fluid accumulation in the abdomen

Cancer is never a single story. Each result gives another piece of information.

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What Did This Mean for Treatment?

This PET/CT changed the direction of our journey.

At this stage, the focus was no longer only about removing one tumor. The treatment needed to address the entire body.

Because this appeared to be advanced lung cancer, the next important question became:

What type of lung cancer is it, and what treatment can target it most effectively?

This is why genetic testing became so important.

For patients with certain genetic mutations, especially EGFR mutations, targeted therapies such as Tagrisso (osimertinib) can play an important role.

Instead of attacking cancer cells in a general way, targeted therapy aims to block the specific pathway that allows cancer cells to grow.

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The Next Questions We Needed Answers To

After the PET/CT, we were waiting for several important results:

1. Genetic testing resultsTo understand whether the cancer had specific mutations and whether the current targeted treatment was still the right approach.
2. Testing of the pericardial fluidBecause fluid had accumulated around the heart, we needed to know whether it was related to the cancer or another cause.
3. MRI resultsTo better understand the brain findings.

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Looking back at this scan now, I realize this was one of the moments when our understanding of the disease changed.

The PET/CT did not just show images.

It showed us the path ahead.

There were many questions, but each test brought us closer to the answers we needed.

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(To be continued: Brain MRI Findings and What We Learned Next)