27 Questions
What is the main purpose of accurate staging of malignant disease?
To provide appropriate management for a particular patient
What can happen if a patient is overstaged?
They may not receive curative treatment
What is the consequence of understaging?
The patient may undergo futile treatments
What is the role of imaging in staging?
It plays a significant role
What is the established value of bone imaging using 99mTc MDP and 18F?
Detecting metastatic bone disease
What is the ideal method of staging?
Microscopic examination
What is the accuracy of 18F FDG-PET in staging tumors?
Better than 90%
What is the accuracy of CT in staging mediastinal disease in lung cancer?
Around 70%
What is the accuracy of MRI in staging mediastinal disease in lung cancer?
Around 80%
Why is accurate staging of malignant disease crucial at the time of initial presentation?
To provide appropriate management for the patient
What can occur if a patient's cancer is not properly staged?
The patient may not receive the correct treatment
What is the significance of 99mTc MDP and 18F in staging?
They are used to detect metastatic bone disease
Why are nuclear medicine procedures, such as 18F FDG-PET, important in staging?
They have a higher degree of accuracy compared to CT or MRI
What is the benefit of using 18F FDG-PET in staging lymph node involvement?
It has a higher degree of accuracy compared to CT or MRI
What is the limitation of microscopic staging?
It is not possible to biopsy every lesion
Why are radiopharmaceuticals used in staging and follow-up of neuroendocrine tumors?
To monitor the patient's response to treatment
What is the significance of staging in determining the patient's treatment?
It determines the appropriate management for the patient
What is the consequence of inaccurate staging on the patient's outcome?
The patient may not receive the correct treatment
What can lead to a patient receiving futile but drastic treatments that increase morbidity and mortality?
Understaging of malignant disease
Which of the following imaging modalities has the highest accuracy in staging mediastinal disease in lung cancer?
18F FDG-PET scan
What is the primary limitation of microscopic staging?
It is not possible to biopsy every lesion
What is the consequence of a patient being deprived of curative treatment such as surgery?
Overstaging of malignant disease
What is the role of radiopharmaceuticals in neuroendocrine tumors?
For staging and follow-up
What is the significance of accurate staging of malignant disease at the time of initial presentation?
To provide appropriate management for a particular patient
What is the benefit of using nuclear medicine procedures in staging?
They are more accurate than CT or MRI
What is the primary goal of staging of malignant disease?
To provide appropriate management for a particular patient
What is the significance of bone imaging using 99mTc MDP and 18F in staging?
It has established value in detecting metastatic bone disease
Study Notes
Staging of Malignant Disease
- Staging of cancer depends on the size of the primary neoplasm, its extent to regional lymph nodes, and the presence or absence of metastasis.
- Accurate staging is crucial at the time of initial presentation to provide appropriate management for a patient.
- Overstaging can deprive a patient from receiving curative treatment, such as surgery, while understaging can lead to futile treatments that increase morbidity and mortality.
- Imaging plays a significant role in staging, with bone imaging using 99mTc MDP and 18F having established value in detecting metastatic bone disease.
- Radiopharmaceuticals are used in staging and follow-up of neuroendocrine tumors.
Importance of Accurate Staging
- Ideal staging is a microscopic process, but it is not always possible to biopsy each lesion to determine if it is malignant.
- Nuclear medicine procedures, such as 18F FDG-PET, have higher accuracy compared to CT or MRI alone in staging tumors, particularly for lymph node involvement.
- The accuracy of CT in staging mediastinal disease in lung cancer is approximately 70%, while MRI is slightly higher at around 80%, and 18F FDG accuracy is better than 90%.
Learn about the importance of accurate staging of malignant lesions, including the factors that determine staging and the consequences of overstaging and understaging.
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