Can different CTs pick up different things?

[Punky44]

So my mom has completed 8 rounds of neoadjuvant Folfox and has been scanned once before starting at our local hospital, once after 4 rounds at our local hospital, and then today after 8 rounds at Mayo in prep for her radiation and surgery.

All scans show decent tumor reduction and now her lymph nodes aren’t even suspicious looking, so everyone was pleased. Her CEA has dropped from 17 to 6, which is another good indicator the chemo is working.

The only weird thing was they said they found a couple new two 2mm spots on her lung that weren’t there from the CTs done at the local hospital. I initially freaked but they pretty much blew it off and said lots of things can show up etc etc and it could have always been there and just not picked up by the CT at our local hospital, and that the tumor shrinkage and CEA decline wouldn’t point to it likely being a met. They said they wouldnt change anything about our upcoming radiation and surgery either.

Does this sound like something I shouldn’t worry about? You guys probably know by now I’m kind of a worrier.

[Lee]

. . . The only weird thing was they said they found a couple new two 2mm spots on her lung that weren’t there from the CTs done at the local hospital. I initially freaked but they pretty much blew it off and said lots of things can show up etc etc and it could have always been there and just not picked up by the CT at our local hospital, .

This happen to me once. Some swollen lymph nodes showed up. Onc was not worried (and if she was not worried, I was not going to worry either). In my case 6 mths later, they were back to normal. Onc told me, they could have been there all along (swollen) and nobody noticed. Onc suspected one of my young children brought a germ home and my nodes were doing their job. Fighting off an infection. And since I was gradually gaining weight over the past few years, she was a happy camper.

I've kind of learned through the years, if they don't worry, I want to follow their lead. And yes, since there is shrinkage, I would take that as a good sign.

Good luck,

Lee

[GrouseMan]

My wife had some nodes that initially they thought might be mets in her lungs but turned out they never changed at all during the 3.5 years she was undergoing Chemo. So in her case - no hers were not mets. They took a watch and wait attitude. This seems to be common - in your case I suspect they were there all along like my wife's, but your local hospital's CT scanner might have missed them in its scans likely because their CT instrument is perhaps and older machine with less resolution than the one at Mayo which probably has newer more cutting edge CT scanners. Also - very small nodes are easy to miss, and a radiologist that doesn't really get the opportunity to test his skill at these sorts of things can also miss seeing them where at a major research institute like Mayo - their radiologists have perhaps seen this many times and has more experience with it. Its probably nothing, and just needs to be monitored. People need to understand that there are limitations to the equipment and skills of radiologists. The machines don't just light up areas and say cancer here - PET's do that but hey are not without limitations as well.

Good Luck

GrouseMan

[hiker]

Hey Punky,

When I was first diagnosed and given a 2 year expiration date by a local facility they told me my liver was "peppered" with tumors. At my first meeting with Dr. D'Angelica at MSK, he told me that was nonsense. He could identify 3 tumors and said they're could be a 4th, because he couldn't tell if 1 of the tumors was actually 2 tumors pressed up next to each other.

And since then, I've had many things show up on CTs that ended up being nothing.

Don't despair.

hiker

[Punky44]

Thank you all so much.

[boxhill]

A very high percentage of thoracic CTs show small lung nodules, and a very high percentage of those are not cancer but the result of an earlier infection or the like.

I have a 2mm lung node myself that was first called "indeterminate" and later deemed probably old calcified evidence of an infection.

So in your mother's case, as in most people's, they will likely just keep an eye on them over time. Right now, they are most likely too small to do anything about anyway. (The first time it was seen, my onc told me that no interventional radiologist would be able to biopsy my 2 mm node. But I wasn't worried in the first place because as soon as I saw the report--before I discussed it with my doctor--I started googling information about lung nodes seen on CT, and gleaned the information about how likely they are to be nothing.)