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Oncology > Imaging > Flashcards

Flashcards in Imaging Deck (57)
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1

Reasons for Imaging in the Management of Cancer

Screening
Making the diagnosis
Staging
Operative planning
Response to treatment
Follow-up

2

Types of Imaging in Cancer

Plain films
CT scans
Fluoroscopy
Mammography
SPECT scans
PET scans
MRI
Ultrasound

3

What are X-rays good for?

Lungs
Kidney/gall stones
Bones

4

X-rays not good for

Soft tissues
Brain

5

What do x-rays rely on?

Differential absorption
Air
Fat
Water
Bone densities

6

Imaging for Bone Lesions

X-rays
CT scans
MRI
PET/CT

7

What are we looking at on x-rays for oncology imaging?

Nature of the bone matrix
Interface of lesion & bone
Cortex intact?
What part of bone?
Benign vs. malignant

8

Define Benign Bone Lesions

Well-defined
No cortical destruction
No periosteal reaction

9

What are CT scans best for evaluating?

Subtle bone changes

10

What are MRI scans best for evaluation of?

Soft-tissue & infiltrative marrow lesions

11

Define Latent Bone Lesions

Surrounded by reactive cortical rim

12

Define Active Bone Lesions

Easily discernible transition without reactive rim

13

Define Aggressive Bone Lesions

Broad infiltrating border

14

Define Fluoroscopy

Continuous X-rays used to obtain real time moving images of internal structures

15

Define CT Scan

X-rays taken in several planes are computer processed to show images in multiple slices: AP, lateral, sagittal, x-section & even as 3D images

16

Advantages of CT Scancs

Differentiate structures of close physical density
Eliminates superimposition of organs
Show calcified & hemorrhagic lesions
Show in multiple planes or even as a 3D image

17

Advantages of CT Scans in Neoplastic Disease

Very good in the abdomen for staging
Very good for evaluation of masses in the chest
Can do virtual colonoscopy
Most intracranial neoplasms are visible

18

Disadvantages of CT Scans

Risk of cancer
Contrast: allergic reactions, anaphylaxis, nephropathy
Expensive
Observer variation

19

Define Pancoast's Tumor

Extension of tumor at apex of the lung involving C8, T1, T2 nerves & possible destruction of ribs

20

Presentation of Pancoast's Tumor

Shoulder pain radiating in the ulnar direction

21

Virtual Colonoscopy

Done with CT
Requires bowel prep
No sedation needed
Not as sensitive as colonoscopy
Can't do biopsies

22

Mammography

Uses low energy X-rays to generate images

23

Abnormal Mammogram

Needs breast examination
Further mammography for confirmation
Ultrasound for better definition
BIRAD classification
MRI with gadolinium- implants very dense
Needle/surgical biopsy may be recommended
Tissue diagnosis key

24

What do nuclear scans measure?

Bone metabolism or remodeling

25

Nuclear Scans

Radio-isotope injected IV
3 hours later, the patient is scanned
Provides 2D image
Function test
Half material goes to the bones
Eliminated through the kidneys

26

Bone Scans

Show increased metabolic activity or increase blood flow
Assess activity or known lesions
Find unknown lesions
Overestimates lesions
MM cold scan until cortical disruption occurs

27

What does PET stand for?

Positron emission tomography

28

What can a PET be combined with?

CT
MRI

29

When are PET scans especially useful?

Lymphomas
Lung CA

30

PET Scans

Detects active, rapidly growing tumors
Higher grade malignancies detected more than benign processes