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A Couple Questions About CT Scans...

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  • A Couple Questions About CT Scans...

    I opted to have my first CT scan after my orchiectomy in the off chance the lesion was benign. The pathology report declared a non-seminoma tumor, so my first CT scan is scheduled for tomorrow. I understand the importance of these scans, but also would like to limit exposure to radiation.

    1) My urologist ordered a chest, abdomen, pelvis scan. Is this normal protocol? I see a lot of people of this forum get abdomen/pelvis scans with a chest x-ray. What are the pros/cons of the latter?

    2) I understand that CT scans are used more often compared to MRIs, but to what extent is this because of tradition? Is this a money, time, and expertise issue or are CT scans really more efficient?

    3) Any questions/requests I should have at the CT scan appointment?

    Thanks in advance!

  • #2
    Well, a few weeks before my husband's cancer was discovered, he happened to have chest x-ray while in the ER for an unrelated issue, and nothing showed up. When he was diagnosed the chest CT showed a LOT of nodules in the lungs. Either they appeared and grew very fast in only about 5 weeks, or they were too small to see on the x-ray. Get the CT.

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    • #3
      As far as I know, CT scans will see much smaller nodules and will see them in much clearer resolution. That has both pros and cons. They pick up nodules as small as just 2mm in dimension which an X-ray will not but an awful lot of small lung nodules are harmless and due to previous infections not cancer. I have two just such nodules, one in each lung. But on the plus side, you can compare CT scans to each other pretty accurately and spot even small changes in that thought to be harmless nodule that might indicate it isnít harmless after all.

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      • #4
        It is my understanding that there is really no need for a chest CT if the abdominal CT is negative and the chest x-ray is negative. Having one at baseline though would not make that big of a deal to me so I probably would not argue the order. Same as a pelvic CT, I believe most cases of spread occur in the abdomen so many times the pelvic are is not imaged during surveillance unless one has had prior pelvic surgery or there are other reasons for doing so. Again, having it done the first time would not bother me greatly.

        MRI is used in countries such as Sweden and Norway but it is my understanding that this is done in a more centralized manner with expert radiologists and set protocols. In my mind the potential harm in miss-interpreting the MRI out weighs any potential benefit of avoiding radiation exposure. At this point I personally would not do MRI unless it was in a clinical trial setting. There is an ongoing trial in the UK looking at the equivalence of MRI and CT.

        There is more information about radiation and CT at: www.dialitdown.org but as long as the CT schedules are reasonable I would be cognizant but not frightened by any radiation exposure, especially with newer technology and if dose controls are being used.

        Mike
        Oct. 2005 felt lump but waited over 7 months.
        06.15.06 "You have Cancer"
        06.26.06 Left I/O
        06.29.06 Personal Cancer Diagnosis Date: Got my own pathology report from medical records.
        06.30.06 It's Official - Stage I Seminoma
        Surveillance...
        Founded the Testicular Cancer Society
        6.29.13 Summited Mt. Kilimanjaro for 7th Cancerversary

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