Non-Small Cell Lung Carcinoma Overview
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Questions and Answers

Which feature of a nodule is least likely to suggest malignancy?

  • Irregular borders
  • Well-defined edges (correct)
  • Spiculated edges
  • Heterogeneity within the nodule

What is the significance of the nodule being classified as a T1 tumor in the TNM staging system?

  • It has spread to lymph nodes
  • It is less than 3 cm in size (correct)
  • It is of a benign nature
  • It indicates a metastatic disease

How does the RIS enhance workflow in managing CT procedures?

  • By limiting access to images for radiologists
  • By tracking the status from order entry to image interpretation (correct)
  • By ensuring images are not shared
  • By replacing the need for PACS

In what way does PACS improve patient care coordination?

<p>By allowing simultaneous access by multiple authorized users (A)</p> Signup and view all the answers

What is the primary role of PACS in relation to CT imaging results?

<p>To store and facilitate access to images digitally (B)</p> Signup and view all the answers

What is the primary characteristic that identifies the mass in the patient's lung as potentially malignant?

<p>Irregular borders observed on the CT scan (B)</p> Signup and view all the answers

Which of the following statements best explains why a CT scan is preferred over a chest X-ray for evaluating lung nodules?

<p>CT scans provide high-resolution images and better detail of nodule characteristics (D)</p> Signup and view all the answers

Given the patient's age and smoking history, which symptom is most indicative of a potential lung cancer diagnosis?

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

What crucial step must be taken when preparing a patient for a CT scan involving IV contrast?

<p>Review the patient's medical history for allergies to IV contrast (A)</p> Signup and view all the answers

Which acquisition parameter is crucial for obtaining higher spatial resolution in a CT scan?

<p>Implementing a thin-slice protocol (e.g., 1-2 mm slice thickness) (B)</p> Signup and view all the answers

Flashcards

Non-small cell lung carcinoma (NSCLC)

A type of lung cancer, making up about 85% of lung cancer cases, often related to smoking.

CT scan for lung nodules

Provides detailed images of lung nodules, aiding in determining size, shape, and location for malignancy.

Lung cancer risk factors

Factors that increase chances of developing lung cancer, including age and smoking history.

CT scan preparation

Involves explaining the procedure, checking for allergies (especially to contrast), and evaluating kidney function if contrast is used.

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CT scan positioning

Patient lies on back, arms above head to avoid image distortion and allow proper visualization of the lung area during the scan

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CT Scan for Lesion Evaluation

Non-contrast and contrast-enhanced CT scans are used to evaluate if a lesion enhances.

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MPR for Nodule Analysis

Multiplanar reconstruction (MPR) is used to view a nodule from different angles for better analysis.

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Suspicious Lung Nodule Characteristics

A 3cm nodule with irregular borders, spiculated edges, and heterogeneity suggests malignancy.

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T1 Tumor Staging

A 3cm lung nodule is classified as a T1 tumor in the TNM system.

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PACS (Picture Archiving and Communication System)

Digital storage and access system for medical images. Allows multiple users concurrent access.

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Study Notes

Scenario

  • 60-year-old smoker with chronic cough and chest pain
  • Chest X-ray shows suspicious mass
  • CT scan reveals 3 cm nodule in right upper lobe
  • Irregular borders suggest malignancy
  • Biopsy confirms non-small cell lung carcinoma (NSCLC)

Identify Pathology

  • NSCLC accounts for 85% of lung cancers
  • Often associated with smoking
  • Irregular borders and upper lobe location on CT scan suggest malignancy

Why CT Scan is Best Modality

  • High-resolution cross-sectional images for detailed visualization of lung nodules
  • 3D imaging for assessing nodule size, shape, and location
  • More sensitive than X-ray in detecting small lesions, important for early diagnosis
  • IV contrast helps differentiate benign from malignant lesions

Patient History & Symptoms

  • 60 years old with smoking history: Increased risk of lung cancer
  • Chronic cough and chest pain: Common symptoms related to tumor growth and impact on nearby structures
  • Suspicious chest X-ray findings: Requires further investigation (CT scan)

How to Perform the CT Scan

  • Preparation: Explain procedure to patient, ensure understanding of IV contrast need. Inquire about allergies and renal function if contrast used.
  • Positioning: Patient positioned supine, arms elevated above head to prevent artifacts
  • Acquisition Parameters: Thin-slice protocol (e.g., 1-2 mm) for higher spatial resolution. Non-contrast and contrast-enhanced scans if indicated.

Post-Processing

  • Multiplanar reconstruction (MPR) for better nodule evaluation in various planes

Analyze CT Scan (Image)**

  • Nodule characteristics: 3 cm, irregular borders, suggestive of malignancy
  • Location: Right upper lobe is a common primary lung cancer site
  • Size: T1 tumor in TNM staging (needs further evaluation)

Confirm Diagnosis

  • Biopsy confirmation required for final NSCLC diagnosis
  • Histopathological examination provides type (e.g., adenocarcinoma, squamous cell carcinoma) and cellular characteristics

Discuss How Images are Stored & Accessed using PACS

  • Images stored in Picture Archiving and Communication System (PACS)
  • Digital storage, access by multiple users simultaneously
  • Tools for image manipulation and sharing

Role of RIS in Scheduling & Managing CT Procedures

  • Scheduling: Radiology Information System (RIS) manages appointments, patient preparation, and resources.
  • Workflow Management: Tracks procedures, from order to image interpretation.
  • Communication: Links with PACS, ensuring correct image labeling and organization

Discuss How the Patient's EHR Integrates Imaging Results into the HIS

  • Integration of imaging results (from RIS and PACS) into the Hospital Information System (HIS)
  • Comprehensive record with history, lab results, and imaging findings
  • Access to imaging by authorized healthcare providers for better decisions and follow-up

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Description

This quiz provides a comprehensive overview of Non-Small Cell Lung Carcinoma (NSCLC), including its association with smoking and diagnostic imaging techniques. Participants will explore the characteristics, pathology, and the importance of CT scans in detecting lung nodules. Test your knowledge on this prevalent type of lung cancer and its clinical implications.

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