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python3 -c " import pdfplumber with pdfplumber.open('/tmp/workspace/attachments/cf35f527-903c-4afa-8f11-34cf16c76797/SAMRATBEN G PARMAR - 07082025 - F_260717_181308.pdf') as pdf: print(f'Total pages: {len(pdf.pages)}') for i, page in enumerate(pdf.pages): print(f'\n=== PAGE {i+1} ===') text = page.extract_text() print(text) tables = page.extract_tables() if tables: print(f'[{len(tables)} table(s) found]') for t_idx, table in enumerate(tables): print(f'Table {t_idx+1}:') for row in table: print(row) "

This is a Whole Body Digital PET-CT Scan report for a breast cancer patient. Here is a full breakdown:

Patient & Scan Overview

FieldDetail
PatientSamratben Ganpatsinh Parmar, Female, 42 years
Date17 July 2026
Referring DoctorDr. Nikunj Vithalani (MS, DNB Surgical Oncology)
Scan Type18F-FDG Whole Body Digital PET-CT (AI-assisted, 160-slice)
Tracer Dose5.6 mCi 18F-FDG
Scan CoverageVertex (top of head) to mid-thigh
Reporting CentrePrisma, Zenon Building, Surat, Gujarat

Clinical Background

The patient is a known and operated case of left breast cancer (carcinoma). Her treatment history:
  • Surgery (20 Dec 2025): Wide excision lumpectomy of left breast + left axillary node clearance. Histopathology showed no definite residual invasive carcinoma; only a tiny 0.1 cm focus of probable DCIS (Ductal Carcinoma In Situ). All 21 lymph nodes removed were tumor-free (pN0). No perineurial or lymphovascular invasion.
  • Radiotherapy: Completed by 07 Feb 2026.
  • Targeted Therapy: Last dose 30 June 2026.
  • This scan is for follow-up evaluation.

Findings by Region

Brain

Normal physiological FDG uptake. No obvious lesion. (Note: MRI brain recommended if clinically needed, as not all brain lesions are visible on PET-CT.)

Head & Neck

  • Metallic denture artefact limits oral cavity assessment.
  • Mild bilateral tonsillar fossa inflammatory thickening.
  • A few reactive lymph nodes in bilateral level II cervical regions.
  • Salivary glands, vocal cords, and lymphoid tissue all appear normal.

Chest (Key Area - Left Breast)

  • Post-surgery changes confirmed - lumpectomy site and left axillary clearance site show no abnormal metabolically active soft tissue (no residual or recurrent disease).
  • Ill-defined fibrotic changes with faint metabolism at lumpectomy site - likely minimal post-treatment inflammatory changes only.
  • Mild diffuse left breast skin thickening (max 9 mm) - likely post-radiotherapy changes.
  • Fibrotic opacity with faint metabolism at left axillary region, no heterogeneous enhancement (SUVmax 4.3) - likely inflammatory, not malignant.
  • No significant lymphadenopathy in supraclavicular, internal mammary, or mediastinal regions.
  • Prior lymph nodes at left level IV cervical and left supraclavicular regions have further regressed in size and are now barely visible.

Right Axilla

  • Previously noted prominent lymph nodes (11 x 6 mm, SUVmax 4.1) have regressed to 7 x 5 mm and are now ametabolic (inactive). Fatty hilum preserved - benign appearance.

Lungs

  • Subpleural atelectatic changes in left lung anterior region (post-radiotherapy).
  • Patchy air trapping in bilateral lower lobes and left upper lobe.
  • No metabolically active pulmonary nodule.
  • No pleural or pericardial effusion.

Abdomen & Pelvis

  • Mild fatty liver - no focal active lesion in liver or spleen.
  • No metabolically active retroperitoneal or abdominopelvic lymphadenopathy.
  • Gallbladder, pancreas, adrenals, and uterus/adnexa all appear unremarkable.

Musculoskeletal / Bones

  • Post-radiotherapy changes in dorsal spine noted.
  • Faint radiotracer uptake in vertebrae and pelvic bones without CT-evident lytic/sclerotic lesions - likely post-treatment reactive marrow changes.
  • No suspicious bone lesion or pathological uptake elsewhere.

Conclusion (Summary)

Compared to the prior PET-CT (06 Aug 2025) and pre-operative CT (09 Dec 2025), this scan shows:
Complete metabolic and morphological response to treatment is the likely conclusion.
Key positive findings:
  1. No residual or recurrent disease at the lumpectomy or axillary clearance sites.
  2. Previously noted lymph nodes in cervical, supraclavicular, and right axillary regions have regressed further and are now inactive/barely visible.
  3. No evidence of metabolically active disease anywhere in the body.
  4. Changes seen are consistent with post-surgical and post-radiotherapy healing.
Recommendation: Routine interval follow-up as clinically indicated.

Reporting Team (Prisma, Surat)

The report was signed off by a multidisciplinary team including nuclear medicine physicians, oncologic radiologists, and consultant radiologists (Dr. Manas Mayank, Dr. Vishal Makawana, Dr. Krishan Kant Agarwal, Dr. Keyur Mandaliya, and others).
In summary, this is a very encouraging follow-up scan - the patient's breast cancer appears to have responded completely to her treatment regimen of surgery, radiotherapy, and targeted therapy. No active disease is detectable in the body at this time.
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