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How to interpret c-scans

Monicaemilia's picture
Posts: 455
Joined: Nov 2006

I was told in November that a couple of spots were seen in the lungs, too small to biopsy. I had a c-scan last week and the report says nothing about the lungs, and the summary states: The CT-visible metastases remain confined to the liver in the abdomen and pelvis. My onc told me the spots in the lungs were still there, but I'm having a real hard time finding it in the report. Is 'visible' the operative word? Is it possible that due to the size it would not show up in the written report? Thanks for your help. Monica

shmurciakova's picture
Posts: 910
Joined: Dec 2002

I would assume they are unchanged and that is why they were not mentioned in the report. If they have not grown that is fantastic news. If they were cancer, I would presume they would have grown in that period of time (mine did). I don't know if visible is the operative word because they are visible, so.....hmmm. I guess the radiologist did not think they were cause for concern.
Best wishes,

vinny3's picture
Posts: 933
Joined: Jun 2006

If different radiologists read the scans that may account for the difference. I had "spots" too but the radiation oncologist I saw before my initial chemoradiation said those were commonly seen and not to worry. If you want to be sure I suggest getting copies of the reports for your records (which I think is a good idea for all of the tests we have rather than relying solely on someone else telling us the result) and if there were two different radiologists reading the separate scans ask the first one to look at the second scan and give an opinion about the spots. If you don't wish to call the radiologist ask your doctor to do so.


Betsydoglover's picture
Posts: 1256
Joined: Jul 2005

Hi Monica -

The one thing I have learned and something my oncologist confirms is that radiologists choose to comment on whatever it is they choose to comment on. If your scans are being read by different radiologists, it could well be that one decided to comment on the lung spots just because and the other did not because he/she didn't think they were clinically significant. I wouldn't read too much into specific words - humans are writing the reports and they can vary in the words they use on any given day.

Given that the lung spots were not mentioned, it probably means they haven't changed in size which may well mean they are not significant. Lots of folks, me included, have "things" that show up in the lungs, but don't mean anything. I was 11 months into this journey before my second set of NIH scans mentioned lung spots - turned out they had been there all along, but previous radiologists did not consider them to be clinically significant.

You should talk to your oncologist. Other than my two evals at NIH and my first pre-surgery CT scan, my scans have been done at the same facility and studied by the same radiologist. My oncologist believes in him and thus so do I. She is very disturbed about some radiology centers that just report things like "worse" or "better". Clear to me that radiology reports are all very different and you should get a copy of your reports and then discuss your questions with your oncologist. My radiologist is actually one of the few, according to my experience and my oncologist's experience, who has a personality and will talk with patients. But even if yours is the more usual closet type, you should be able to talk with your onc and get a better idea of what is going on.

Take care,

Monicaemilia's picture
Posts: 455
Joined: Nov 2006

Susan, Dick and Betsy: Thanks for your advice. What concerned me is how certain my onc was that it was 'cancer', when the reports did not even mention the spots. My other concern was that she told me in November that if the spots disappeared while on chemo, then it was cancer, and if they remained, they more than likely were something else. I think I'm more disturbed with my onc than with the radiologist, she seems to be all over the place. Monica

nudgie's picture
Posts: 1482
Joined: Sep 2006

I had my first CT Scan on 25 Jan 07 and my report broke down each area including the lungs. My Onc Doc ordered a CT of the the entire chest, stomach and pelvis areas. I have also been getting CT Scans (w/o contrast) for a few years in regards to lung nodules that were found for other reasons. So I took copies of the last two CT Reports (w/o pictures) to my 25 Jan 07 appt. The radiologist used those for the new one and it stated that I had 4 nodues in my lower right. Largest measuring 7mm and smallest in left lung mesauring 4mm.

If you have had previous CT Scans for the lungs and these nodules showed-up get copies of the reports and pictures, if needed, and have your Onc Doc and current radiologist read them against the newest one.

NOTE: The 25 Jan 07 CT Scan was with contrast.

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