Report from Victoria Hospital
Prince Albert, Saskatchewan, Canada
Diagnostic Imaging Report
Exam Date 2003 November 28

CT ABDOMEN and Pelvis (Plain, Dynamic and Delayed)

Axial 10-mm cuts were obtained from the diaphragm to the symphysis pubis. Additional 10-mm cuts were also obtained through the liver during the dynamic intravenous administration of 100 cc Optiray 320. Delayed images were obtained three or four minutes later, with 10-mm axial slices through the liver, but then switching to a urinary tract 5 x 8 mm protocol to try and elucidate the obstructed right kidney, better than on the previous examination.

The four focal hepatic lesions are again seen, and these have essentially doubled in diameter since October 8. The ones high in the right and left lobes measure 12 and 16 mm respectively. The lesion near the gallbladder measures 16 mm and the one peripherally in the right lobe half way down measures 14 mm. Unfortunately, there are two new lesions lower towards the tip of the right hepatic lobe (images 58 and 57) with the anterior one measuring 9 mm and the more posterior one measuring 6 or 7 mm. The latter two are virtually invisible on the plain portion of the scan, but the others have become more visible on the plain scan as they have grown.

The moderately right hydronephrosis is unchanged. I can track the ureter better with the finer cuts, and it definitely does change caliber right where it abuts the rectal tumor recurrence (projecting anteriorly to the right of the rectum). The rectal wall is looking thicker than it did, but this may be due to the fact that it is a little more deflated. No left hydronephrosis. No other new feature.

I am afraid that the experimental therapy does not seem to have made much effect on the relatively rapid progression in just seven weeks.

Dr. I. C. Waddell (radiologist)

cc: Dr. Randy Friesen
cc: Dr. Rod Unsworth