Cancer Imaging

Question 1

State the first 3 stages of the cancer management pathway.

Answer 1

Prevent. Predict. Detect.

Question 2

State the last 3 stages of the cancer management pathway.

Answer 2

Stage. Treat. Track.

Question 3

State which symptoms an ultrasound is used to evaluate.

Answer 3

Pain. Swelling. Infection.

Question 4

State which internal organs ultrasound is used for.

Answer 4

Heart. Blood vessels. Liver. Gall bladder. Spleen. Pancreas. Kidneys.

Question 5

State one thing a CT scan is used for.

Answer 5

Bone fractures. Tumours. Cancer monitoring. Finding internal bleeding.

Question 6

State one thing an MRI machine is used to diagnose.

Answer 6

Joints. Brain. Wrists. Ankles. Breasts. Heart. Blood vessels.

Question 7

State one thing used in hybrid imaging.

Answer 7

18F Fluorodeoxyglucose (FDG) PET.

Question 8

Define sensitivity.

Answer 8

Proportion of people with disease who have a positive test.

Question 9

Define specificity.

Answer 9

Proportion of people free of a disease who have a negative test.

Question 10

Define accuracy.

Answer 10

Overall proportion of correct test results.

Question 11

Define Negative Predictive Value (NPV).

Answer 11

Proportion of people with a negative test who are free of disease.

Question 12

Define Positive Predictive Value (NPV).

Answer 12

Proportion of people with a positive test who have disease.

Question 13

What does TMN stand for?

Answer 13

T - primary tumour (size/local advancement 1-4)
M - involved local nodes (by number 0-3)
N - distant metastatic spread (0-1)

Question 14

State one feature of T1 in lung cancer.

Answer 14

Size < 3cm. No invasion of the main bronchus. Surrounded by lung or visceral pleura.

Question 15

State one feature of T2 in lung cancer.

Answer 15

Size 3-7cm. Involves main bronchus distal from carina (ridge of cartilage in the trachea). No invasion of the chest wall.

Question 16

State one feature of T3 in lung cancer.

Answer 16

Size > 7cm. Involves the main bronchus <2cm from carina (ridge of cartilage in the trachea). Invasion of the chest wall, diaphragm, mediastinal pleura, parietal pericardium.

Question 17

State one feature of T4 in lung cancer.

Answer 17

Invasion of the mediastinum great vessels, heart carina, trachea, oesophagus, vertebra.

Question 18

State N Staging.

Answer 18

N0 - No nodal disease
N1 - Ipsilateral hilar disease
N2 - Ipsilateral mediastinal or subcarinal disease
N3 - Contralateral hilar of mediastinal disease

Question 19

State M Staging.

Answer 19

M0 - no metastases
M1a - bilateral pulmonary disease
M1b - distant organ spread
M1c - >1 distant metastatic site (spread to more than one organ)

Question 20

State a locoregional therapy.

Answer 20

Ablative therapy (minimally invasive procedure to destroy abnormal tissue).

Question 21

State a systemic therapy.

Answer 21

Drug therapy - chemotherapy, targeted therapies.

Question 22

Define a phase 1 trial.

Answer 22

Small no. of patients. Safety/toxicity/dosage.

Question 23

Define a phase 2 trial.

Answer 23

Small no. of patients. Drug effectiveness. Safety.

Question 24

Define a phase 3 trial.

Answer 24

Large no. of patients. Randomisation. Tested vs standard treatment.

Question 25

State 2 elements of the Response Assessment Methodology.

Answer 25

Complete Response (CR) - disappearance of all target lesions/all nodes <10mm. 
Partial Response (PR) - >30% decrease in the sum of TL diameters. 
Stable Disease (SD) - neither PR nor PD
Progressive Disease (PD) - >20% increase in the sum of TL diameters