Ct scans

[Buckeye]

I don’t understand how things change from one scan to the next. I just received my 2 year annual scan and I am still cancer free. No evidence of metastatic disease. They did however note I have a 1.5cm nodule on the right lobe of thyroid and 2mm kidney stone. My previous scans have both mentioned a liver cyst and a nodule in my lung. This scans says both are clear? Do these things just pop up and disappear like magic? I am glad I’m cancer free, but this thyroid nodule is bugging me. Was it there on previous scans and no one mentioned it? 1.5cm seems big to me, but I guess it’s nothing since they didn’t mention it in the impression notes. How do the other nodules just disappear? They have been stable for years? I’m just frustrated with these ct scans picking up every little nit picking thing and trying to scare me to death.

[susie0915]

I just emailed my oncologist about the same type of thing. It said stable thickening in adrenal gland, but no previous scan mentioned it before. I also have a small 4mm lung nodule that was seen was mentioned in may, 2017 scan and repeat scan 3 months later showed no change, so being watched. The impression said no evidence of metastatic disease as well. My oncologist just responded by saying radiologists word findings differently and may report something that another would not. So I decided to just be happy there was no evidence of disease and if there was something suspicious it would be mentioned. As, when the lung nodule was seen last may the radiologist recommended even though it is nonspecific because of cancer history should be monitored. Congrats on no evidence of disease, and focus on that.

[mhf1986]

We've had 2 oncologists tell us that radiologists are hyper about mentioning things, almost like they are trying to one-up the last guy. I wonder how much of it is lawsuit driven: if they don't mention it then there's a potential lawsuit if it is something later.

We've also been told that growing 1mm for lung nodes in 3 months is a measuring issue because of movement. My favorite was when the oncologists said the radiologists had too much coffee and there was too much drama in the surgery center. But I agree, reading those reports is totally scary, I don't know what to worry about some days. Our next report is tomorrow night so we'll see again!

[crazylife]

It drives me mad! 7 lung nodules one scan and now only 3. I am grateful for that, but it drives me mad. I do think it depends on the radiologist.

[mpbser]

I'm very skeptical about CT scans. None of my husband's scans ever showed his liver masses and completely missed a 6-7cm mass in his transverse colon at the juncture of the ascending colon! Going forward, we are not having CT scans, at least not at our local hospital where the Radiology Department seems to be lacking in the highest quality machinery and skillful radiologists.

[menreeq]

Thyroid:
Chest CT scans usually include only part of the thyroid. Depending on where your scan starts, it could have not been in the field of view of prior scans. Alternatively, someone could have seen it but declined to mention it because it didn't look suspicious (low density lesions in the thyroid are very common and better evaluated with ultrasound). Then, they could also have just missed it. If you're worried, ask for a thyroid ultrasound. The caveat is that lots of these thyroid lesions end up being biopsied because telling benign from malignant based on imaging is really hard.

Lung nodules:
If very small, these may not be seen from scan to scan depending on the slice thickness of the CT. It also depends on how much of a breath you take in. Some radiologists don't bother mentioning every ditzel because nodules less than 4 or 6 mm (depending on which guidelines are being followed) are "nonspecific" and could be nothing to worry about -- post infectious, post inflammatory, etc. They are too small to biopsy and too small to see on PET. Each radiologist decides how detailed to be in general.

Kidney stones:
These can definitely disappear from scan to scan (or reappear!). Drink lots of water.

As to why one radiologist does one thing and another does another. I doubt it is because one is trying to "one up" the other. Most are trying to do what is best for the patient. Some may think not mentioning every little thing will decrease patient anxiety. Others think that it is best to mention everything so that attention is paid to those things on the next scan. It is a matter of style.

CT is not the best test for most cancers of the gastrointestinal system. Endoscopy and colonoscopy are standard of care. CT colonography has yet to surpass colonoscopy as the screening test of choice.