Scans and Imaging - how do doctors handle possibility of false negatives or false positives ?
I realize this might be obvious to some but its just not clear to me; I have not gone thru this yet but need to very soon.
I am asking at a very high level - my questions are about how oncologists or other doctors handle the possibility of false positive or false negative results of an image scan (and perhaps how they make sure some positive report item is diagnosed correctly in itself)
I have read in general about common situations of false positives or false negatives, where treatment started that should not have or treatment was not started that should have, as a result of these false results.
And am asking about someone who has had recurrence of the pca after treatment; not asking about initial diagnosis or treatment. (my treatment was imrt with 6 months adt, there was no surgery done but am asking at a high level and realize my questions can apply to anyone who needs to get scans)
Am not asking about any specific imaging type but assuming CT and bone scans (but not referring to acetate or choline ones since I wil not be able to get those though realize for my questions it does not matter, since am not asking about any certain psa value at time of scan)
Do doctors just accept the reported scan results and then, if they feel treatment is needed based on those results and other data, (or if treatment has been going on already) do they just start or stop or modify the treatment based on those scan results (plus other data they have like psa, psadt, etc) ?
Do they make no treatment decisions based just on that scan itself and instead do the scan again after some time. to make sure that the first scan was not a false negative or positive - that is, assumption here is that the 2nd scan would confirm or not the first scan ?
(yet I realize there could be false negatives or positives in 2nd scan also or not as well, and thus how would one know the 2nd one was any more accurate than the first one, and also, that things could have changed in between the first scan where there could be things that showed in second scan that did not show in first (for example that psa was higher at time of 2nd scan and thus indirectly something showed then that did not show before)
Do they take some other actions related to interpreting the scans and using that data as part of their decision making on how to proceed ?
I realize that perhaps my questions might not be logical if a Dr. cannot know at time of scan results if a given scan is true positive or true negative or false positive or false negative ?
PS - I guess the topic of possibility of mis-diagnosis of a given scan result (whether it was true positive or false positive/negative, is another question in this area - how they make sure its really say a metastases to bone or soft tissue areas vs some other thing not related to the pca which would not treatment.
Anyway, thanks for your patience with reading my questions.
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