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Accuracy of CT scans in Right Colon Cancer

SandiaBuddy's picture
SandiaBuddy
Posts: 878
Joined: Apr 2017

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%.

Annabelle41415's picture
Annabelle41415
Posts: 6183
Joined: Feb 2009

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's picture
SandiaBuddy
Posts: 878
Joined: Apr 2017

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.

Annabelle41415's picture
Annabelle41415
Posts: 6183
Joined: Feb 2009

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

Djspareme's picture
Djspareme
Posts: 18
Joined: Mar 2019

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.

Annabelle41415's picture
Annabelle41415
Posts: 6183
Joined: Feb 2009

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

Trubrit's picture
Trubrit
Posts: 4828
Joined: Jan 2013

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's picture
Butt
Posts: 299
Joined: May 2018

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.

linda7408
Posts: 21
Joined: Mar 2018

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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