Accuracy of CT scans in Right Colon Cancer

SandiaBuddy
SandiaBuddy Member Posts: 1,381 Member
in Colorectal Cancer #1

Here's a scary one: CT scans were inaccurate in almost half of the scans examined: https://www.ncbi.nlm.nih.gov/pubmed/30870227

Of 150 CT scans reviewed, CT failed to identify primary cancer in 19.3%. Overall accuracy of CT to identify unfavorable pathologic features was 63% with sensitivity, specificity, positive predictive value, and negative predictive value of 63% (95% CI, 54%-71%), 63% (95% CI, 46%-81%), 87% (95% CI, 80%-94%) and 30% (95% CI, 18%-41%). Only cT3/4 (55% vs 45%; p = 0.001) and cN+ (42% vs 58%; p = 0.02) were significantly associated with correct identification of unfavorable features at final pathology. CT scans overstaged and understaged cT in 23.7% and 48.3% and cN in 28.7% and 53.0% of cases. . . Accuracy of CT scan for identification of pT3/4, pN+, or pre-extramural venous invasion positivity was insufficient to allow for proper identification of patients at high risk for local recurrence and/or in whom to consider alternative treatment strategies. Locoregional overstaging and understaging resulted in inappropriate treatment strategies in <48%.

Comments

  • Annabelle41415
    Annabelle41415 Member Posts: 6,742 Member
    #2
    Scan

    Being that mine was in the rectum, my radiologist could hardly see it so I'm thinking that if they didn't know where it was, they might not have spotted it.  I'm confident that the real good detection for colon or rectal cancer is a scope.  That way it is closer up and they can see with a camera everything that needs to be seen.

    Kim

  • SandiaBuddy
    SandiaBuddy Member Posts: 1,381 Member
    #3
    Annabelle41415 said:

    Scan

    Being that mine was in the rectum, my radiologist could hardly see it so I'm thinking that if they didn't know where it was, they might not have spotted it.  I'm confident that the real good detection for colon or rectal cancer is a scope.  That way it is closer up and they can see with a camera everything that needs to be seen.

    Kim

    Accuracy

    For me, it was a bit weird.  Despite both a CT and a colonoscopy, it turns out the tumor was not where they expected it.  For me, it meant removing less of the colon, which was a good thing.  But it also makes me wonder about the accuracy of a CT scan to evaluate whether or not there is a recurrence.

  • Djspareme
    Djspareme Member Posts: 22 Member
    #4
    Both of my last 2 CT scans

    Both of my last 2 CT scans have come back clean.  Im scheduled for both a CT and PET in May.  My CEA is 2 and blood work looks good.  I was told Thursday I'm in remission, but that was based on the CT scans.  Makes me wonder if the lady bee an error.  Still celebrating and I'll deal with any issues after May.

  • Trubrit
    Trubrit Member Posts: 5,804 Member
    #5
    CT & PET

    I had a clear CT Scan followed by a PET Scan the same day.  The CT picked up nothing, the PET picked up a tumour that ended up being 2.2 cm. 

    Tru

  • Butt
    Butt Member Posts: 352 Member
    #6

    CT was reading that I have a benign cyst in my colon and liver hemangioma. it is a benign cyst. It was a cancer tumor and a liver met. Butt.

  • Annabelle41415
    Annabelle41415 Member Posts: 6,742 Member
    #7
    SandiaBuddy said:

    Accuracy

    For me, it was a bit weird.  Despite both a CT and a colonoscopy, it turns out the tumor was not where they expected it.  For me, it meant removing less of the colon, which was a good thing.  But it also makes me wonder about the accuracy of a CT scan to evaluate whether or not there is a recurrence.

    Exactly

    I'm not confident in a CT scan to see if there is one in the colon or rectum.  Other areas and organs outside of that I'm more confident.  Inside the colon is a different story.  My surgeon wanted a colonoscopy every two years for 4 years and then 3 years.  I'm more comfortable with that testing and never the home test were you just send your sample away.

    Kim

  • Annabelle41415
    Annabelle41415 Member Posts: 6,742 Member
    #8
    Djspareme said:

    Both of my last 2 CT scans

    Both of my last 2 CT scans have come back clean.  Im scheduled for both a CT and PET in May.  My CEA is 2 and blood work looks good.  I was told Thursday I'm in remission, but that was based on the CT scans.  Makes me wonder if the lady bee an error.  Still celebrating and I'll deal with any issues after May.

    Scans

    I'm still a believer that CT scans are a good detection for organs, just not so much the inside of colon for polyps and such as those need to be biopsed.  You are good to celebrate and you deserve it.

    Kim

  • linda7408
    linda7408 Member Posts: 21
    #9
    Scans

    I had a cat scan near my home that said I was NED. A week later my Oncologist had me have one at the hospital where I normally

    go an hour away. It said I had 5 lung nodules. That is what it has been. I think it is the person reading and reporting from the scan,

    not the scanners themselves.

     

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