Friday, April 17, 2009

Just waiting

Good morning! The waiting has officially begun. Yesterday Sydney completed both her MIBG and CT scans. This was our first stab at utilizing their new system for these scans. It is actually pretty cool. You see, previous to this system you could have both a Ct and an MIBG scan but they were mutually independent. The CT scan is looking at anatomy. MIBG is looking at physiology. They could be compared separately but it could be difficult to match them up as they both presented data in very different formats from very different angles. The MIBG was basically just a 2-d image of the patient shown from both the front and the back. The CT was a series of 2-d slices that go through the body. Think of it this way. If you took a carrot out of the fridge and took a photo of it that would essentially be the angle of what you would see with an MIBG scan - just a flat picture of a carrot. A CT scan is different. Now take the carrot and slice it into 100 little circles going from top to bottom. Now take a picture of each of those circles (the inside of the carrot). That is what you get with a CT scan. Do you see how it may be difficult to compare these scans?

Well what Cook's has done is that they have been able to alter the MIBG scan to create a 3-d model of the patient. Now, we don't see just a flat picture but we see an actual 3-d hologram. Let me tell you. It is a bit strange to see your daughter spinning around as a 3-d model on the screen. With this they can not only tell where the spot is (i.e. next to the kidney) but they can also tell exactly how deep it is in the abdomen and how large it is as a 3-d model. If all of this was not cool enough they also have a software solution that lines up the CT images and the MIBG so that they are layered within one another. In this way they can be compared directly to one another. We can now see the physiology and the anatomy lined up.

The oncologists and radiologists now have a much better picture of exactly what type of neuroblastoma they are dealing with and exactly where it is located. Is it on the bone or next to the bone? Is it on the liver, next to the liver, or in the liver? This wasn't entirely impossible to tell before with gross disease but it certainly was impossible with small amounts of disease. This new system addresses that. It is a vast improvement.

So, there you go.

Now, the big question, how did Sydney do? In short, she did great. She was an incredible trooper. She even kept an IV in over night so that we would not have to poke her again. She laid flat and still for about an hour before we ushered over to the CT for another 30 minutes more. After all of the excitement we took her back to school where she spent the rest of the day.

As far as the scans are concerned I did not see anything blatantly obvious. That does not mean nothing is there. It just means I did not see it on the microscopic view that I get. None the less, it felt great that there was nothing glaring. It will be this afternoon or Monday morning before we hear anything for sure.

Until then, we wait...

With purpose.

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