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Follow Up CT Scan Results

Kaye2003
Posts: 86
Joined: Mar 2004

I had a CT Scan done on March 25, 2008 and the results were:

“A few nodular densities, which are not definitely calcified, the largest measuring roughly 6 mm in the lateral aspect of the left lower lobe, partially calcified 4 mm nodular density lateral aspect of the right lower lobe and a non calcified 3 mm nodular density anterior aspect of the right middle lobe. Recommend correlation with chest x-ray findings if these are visible on chest x-ray. Recommend continued follow up with chest x-ray to document continued stability over a two year period. If not visible on the chest x-ray, consider follow-up chest CT in six month.”

"Consider follow-up chest CT in 6 months".

Sept 12, 2008 had the follow-up CT done and the results are:

No pneumothorax or effusion. 4mm left lower lobe nodule image 34, static. Bilateral upper lobe and apex emphysematous bleb formation. Multiple right midlung nodular opacities image 32 are also static, largest 5mm laterally. 2mm right middle lobe nodule image 37 is static. No hilar mass.

Continued follow-up at 6 month intervals recommended to confirm two year stability. The 5mm right midlung nodule described above is static but has slightly spiculated margins.

The first CT said:
6mm left lower lobe, (under impressions says: partially calcified)
4mm right lower lobe
3mm right middle lobe

Fridays CT said:
4mm left lower lobe
5mm right midlung, being the largest of multiple
2mm right middle lobe

I don't understand how the sizes are different and how I had a 4mm in the right middle lower lobe the first CT and now a 5mm right midlung on Fridays CT. If I am getting more nodule, shouldn't the ct have picked up all the old ones as well.

And can someone please explain what "spiculated margins" means.

The Rad told my doctor that he compared the two scans and for me not to worry and he would see me again in 6 months.

Please give me your opinions and advise. Naturally, I am concerned that this could indicate lung cancer in the future.

God Bless,
Kaye

jagged
Posts: 55
Joined: Apr 2008

Kaye,

Congratulations on the scan.

I too have run into the same type of discrepansies in CT scans, so I understand your concerns. While not totally releived, here is how my doctor explained it to me:

CT scans are 3D images created by combining image from the body. These images are actually slices of the body, and they are not continuous slices. Each image slice is roughly 10-40 mm apart. What this means is that when the images are combine, there is some drop out areas that is not captured in the slices. That is the 10-40 mm between slices.

What this means in your situation is that if a lesion is small, less then 10-40 mm, it may be missed because of the CT scan resolution. It may fall between the slices on one scan and show up on the next.

CT scans are the medical "Gold Standard" used because of cost and resolution. On the other hand, MRI are expensive yet give the best resolution.

As for spiculated lesions, here's a link. http://radiographics.rsnajnls.org/cgi/content/abstract/13/4/841
The artical is about breasts, but I believe applies to your post.

Google or Dogpile are great search tools for medical terms I don't understand. www.dogpile.com

You asked for opinions: Relax. Your doctor sounds like he is on top of things.

Hope this helps. Good luck to you.

--jag

Kaye2003
Posts: 86
Joined: Mar 2004

jagged:

Thanks for your reply. It sure made me feel better. I just read your personal page. You need to update. You are still here and you helped someone today (me). You and your husband will be in my prayers.

There is something else I would like to ask. This:

"CT scans are 3D images created by combining image from the body. These images are actually slices of the body, and they are not continuous slices. Each image slice is roughly 10-40 mm apart. What this means is that when the images are combine, there is some drop out areas that is not captured in the slices. That is the 10-40 mm between slices."

is how your doc explained the CT Scan. This makes alot of sense to me. But doesn't that mean that I have 5 nodules instead of 3. Doesn't that mean it is worse than I thought? I envy you your positive outlook on your life and situation. I wish I was more like that. My rib cage under my breast (back and front) have been hunting for weeks and the doctor even told me that the nodules are to small to cause pain. My husband says my nerves are whats going to get me.

I know my problems seems so minor compared to yours, so please forgive me for being a baby about this. I tried to contact you private, but I don't see where we can do that on here anymore. (I old to the boards, my husband survivied colorectal cancer in 03).

God bless,
Kaye

jagged
Posts: 55
Joined: Apr 2008

Kaye,

Maybe worse then you thought? Not sure. The treatment is the same and there are more baselines areas to watch. Another person on her personal page says: "You are no sicker today than you were the day before your diagnosis. You just know more. Knowledge is power." I like this view.

My doctor use to tell me: It is his job to be parinoid. When it came to any check up, he really was. This helped me from all the worry. (Ok, not 100%, but a lot.)

Sometimes, I have a positive attitude. Sometimes, not. This week, I have been a real baby. It's ok. My goal is to take care of myself and get back to the gym and what makes me happy, asap.

As for personal page: Where is yours?

I use to update the page weekly or so. There was a page where you could tell when people updated their page and could follow their story. I loved that feature. It is gone. I will update the page when I feel better. Might make it a bit more uplifting :).

Take care and best wishes on your journy.

--jag

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