Lung Cancer Diagnosis and Imaging Techniques

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Questions and Answers

What type of lung cancer was confirmed in the patient?

  • Lung sarcoma
  • Non-small cell lung carcinoma (correct)
  • Small cell lung carcinoma
  • Mesothelioma

What characteristic of the lung nodule suggests malignancy?

  • Location in the lower lobe
  • Regular borders
  • Size of 1 cm
  • Irregular borders (correct)

Why is a CT scan preferred over an X-ray for lung nodule assessment?

  • CT scans use less radiation
  • CT scans do not require patient positioning
  • CT scans are less expensive
  • CT scans can provide 3D imaging (correct)

What symptom is commonly associated with lung cancer in patients?

<p>Chronic cough and chest pain (B)</p> Signup and view all the answers

What is the recommended patient position for a CT scan of the lungs?

<p>Supine with arms elevated (D)</p> Signup and view all the answers

What is an important preparation step when performing a CT scan with IV contrast?

<p>Review renal function and allergies (D)</p> Signup and view all the answers

What is a key advantage of using IV contrast in a CT scan?

<p>It enhances the visualization of blood vessels. (D)</p> Signup and view all the answers

What factor increases the risk of lung cancer in the presented patient?

<p>Smoking history and advanced age (C)</p> Signup and view all the answers

What size classification does a 3 cm nodule fall under in the TNM staging system?

<p>T1 (A)</p> Signup and view all the answers

Which imaging technique is important for better evaluation of nodules?

<p>Multiplanar Reconstruction (MPR) (D)</p> Signup and view all the answers

What does a biopsy confirm in relation to lung nodules?

<p>The presence of non-small cell lung carcinoma (D)</p> Signup and view all the answers

Which system assists in managing appointment times and patient preparation for CT scans?

<p>Radiology Information System (RIS) (B)</p> Signup and view all the answers

Which of the following features in a nodule is suggestive of malignancy?

<p>Irregular borders (A)</p> Signup and view all the answers

What is a primary characteristic of the Picture Archiving and Communication System (PACS)?

<p>It stores images digitally for multiple users to access. (D)</p> Signup and view all the answers

How does the Electronic Health Record (EHR) utilize imaging results?

<p>It integrates imaging results into the Hospital Information System (HIS). (B)</p> Signup and view all the answers

What common image features support the diagnosis of malignancy in lung nodules?

<p>Heterogeneity and spiculated edges (B)</p> Signup and view all the answers

Flashcards

Non-small cell lung carcinoma (NSCLC)

A type of lung cancer that accounts for the majority of lung cancer cases and is often linked to smoking.

CT Scan

A medical imaging technique that creates detailed, cross-sectional images of the lungs to visualize lung nodules.

Lung Nodule

A small mass or swelling in the lung, which can be benign (not cancerous) or malignant (cancerous).

CT Scan - High Resolution

CT scans provide detailed images, enabling better visualization of small lung abnormalities, crucial for early cancer detection.

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CT Scan - 3D Imaging

CT scans' 3D capability helps evaluate the size, shape, and location of lung nodules relative to other structures.

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Smoking and Lung Cancer Risk

Smoking significantly increases the chance of developing lung cancer.

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CT Scan Contrast

Using IV contrast in CT scans helps distinguish potentially cancerous nodules from healthy tissues.

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Patient History Factors (Lung Cancer)

Patient age and smoking history are important factors in assessing lung cancer risk.

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MPR in CT

Multiplanar Reconstruction (MPR) is a post-processing technique used in CT scans to view the nodule from different angles, helping to visualize its shape and size more accurately.

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Spiculated Edges

A lung nodule with spiculated edges has pointy projections extending outward from its perimeter. This pattern is often linked to malignancy, suggesting the nodule may be cancerous.

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Heterogeneity in Nodule

A heterogeneous nodule exhibits variations in density and texture within its structure, potentially indicating a tumor's internal composition.

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TNM Staging

The TNM staging system categorizes cancer based on the size of the primary tumor (T), lymph node involvement (N), and distant metastasis (M). A larger tumor (T1, T2, etc.) indicates a more advanced stage.

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Biopsy for Lung Nodule

A biopsy is a medical procedure where a small sample of tissue from the nodule is taken and examined under a microscope to confirm the presence of cancer and determine its type.

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PACS Function

The Picture Archiving and Communication System (PACS) is a digital system used in healthcare for storing images, such as CT scans, and making them readily accessible to authorized users.

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RIS for Scheduling

The Radiology Information System (RIS) is used for scheduling CT scans, managing patient information, and tracking the progress of procedures.

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EHR Integration

The Electronic Health Record (EHR) integrates all patient information, including imaging results from PACS and RIS, within a single, comprehensive record accessible to healthcare providers.

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Study Notes

Scenario

  • A 60-year-old smoker presents with chronic cough and chest pain.
  • A chest X-ray reveals a suspicious mass.
  • A CT scan confirms a 3cm nodule in the right upper lobe with irregular borders.
  • Biopsy shows non-small cell lung carcinoma (NSCLC).

Identifying Pathology

  • NSCLC accounts for 85% of lung cancers.
  • Smoking is strongly associated with NSCLC.
  • Irregular borders and location (upper lobe) in the nodule suggest malignancy.

Why CT Scan is Best

  • High-resolution cross-sectional images allow for detailed visualization of lung nodules.
  • 3D imaging aids in assessing nodule size, shape, and location.
  • Detects small lesions, crucial for early cancer diagnosis.
  • IV contrast helps differentiate benign from malignant lesions.

Patient History and Symptoms

  • Age (60) and smoking history increase lung cancer risk.
  • Chronic cough and chest pain are common lung cancer symptoms, linked to tumor growth.
  • Suspicious X-ray findings necessitate further investigation (CT scan).

How to Perform the CT Scan

  • Preparation: Inform patient about procedure, including IV contrast, address allergies.
  • Positioning: Supine position with arms elevated to prevent artifacts.
  • Acquisition Parameters: Thin slice protocol (eg.: 1-2mm) for higher spatial resolution, non-contrast and contrast-enhanced scans as needed.

Post-Processing

  • Multiplanar reconstruction (MPR) for better nodule evaluation.

Analyze CT Scan

  • Nodule size (3cm) and irregular borders suggest malignancy.
  • Location in right upper lobe is common in primary lung cancers.
  • Staging assessment (T1) requires further evaluation

Confirm Diagnosis

  • Biopsy confirms non-small cell lung carcinoma.
  • Histological examination provides detailed diagnosis (e.g., adenocarcinoma, squamous cell carcinoma).

How Images are Stored

  • CT images are stored in a Picture Archiving and Communication System (PACS).
  • PACS system allows simultaneous access by multiple users and facilitates manipulation.

Role of RIS in Scheduling

  • Scheduling CT procedures efficiently.
  • Tracks procedures from order entry to image interpretation.
  • Links with PACS to ensure image accuracy and timeliness.

EHR Integration of Imaging Results

  • Electronic Health Record (EHR) integrates imaging results with the Hospital Information System (HIS).
  • Comprehensive patient record, including imaging findings.
  • Access to imaging data assists healthcare providers with informed decisions and follow-up.

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