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P.O.D own flashcards > Imaging in cancer > Flashcards

Imaging in cancer Flashcards

1
Q

when is a barium swallow imaging technique used? AND EXAMPLE

A

only if patient can’t undergo endoscopy i.e esophageal cancer
-rarely used in real practice

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2
Q

Barium info

A

doesn’t react with the body
is excreted safely
xray beams can’t pass through Barium atoms due to high atomic number
appears white in standard xray
but in other scans it can appear black or white
can do barium swallow or barium enema

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3
Q

How does barium show a tumour

A

barium outlines the cancer in a scan

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4
Q

single contrast

A

barium outlines the lumen- can’t see a tumour however

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5
Q

double contrast

A

in addition to outlining the lumen it outlines the tumour so both are visible

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6
Q

CT colonography

A

CO2 gas inserted to open the colon up as much as possible
may have to swallow contrast dye prior
CT examination of the lumen
-fecal tagging due to dye
-tumour wouldn’t retain contrast
- improves the differentiation of residual feces from polyps and thereby false-positives can be avoided.

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7
Q

What does the diagnosing colonic tumours?

A

colonoscopy (endoscopy)

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8
Q

what is the best technique to see colon polyps if they can’t undergo colonoscopy?

A

CT colonography

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9
Q

cross section imaging

A

body in slices

includes CT, MRI & PET

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10
Q

Uses of cross section imaging

A
  • initial diagnosis and staging of disease
  • monitor response to treatment
  • evaluating residual mass after treatment
  • recognition of complications of treatment
  • when there is concern for disease relapse
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11
Q

CT xray

A

body absorbs photons released by x-rays

-various angles around the body to get a 360 degree image

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12
Q

Voxel is how thick? and why

A

1 cm- reduces noise ie in radiological terms- produces a less grainy image (improves quality)

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13
Q

What is used to outline the GI tract?

A

gastrografin- dilute iodine based contrast

- not used routinely nowadays

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14
Q

IV CT contrast agent?

A

iodine based contrast

omnipaque- injected into the veins demonstrate blood vessels or the vascularity of different tissues

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15
Q

Risks of IV contrast use

A

allergic and anaphylactic reactions

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16
Q

diagnosis and staging system

A

T, N, M

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17
Q

T staging

A

TUMOURS

  • very specific to particular organ
  • can’t compare between structures
  • shows depth or position of tumour
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18
Q

N staging

A

involves lymph nodes N= nodes

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19
Q

M staging

A

presence of distant metastases- spreading of cancer elsewhere in body
ie is there no metastasis or distant metastasis present

20
Q

Brain scanning

A

CT, MRI

PET can’t be used- as brain is highly metabolic

21
Q

which scan type is used to see the spinal cord

A

v intricate

MRI is only morality that can see detail

22
Q

which scan type can’t be used to examine the Lungs

A

don’t have H+ protons and MRI depends on these so it can’t be used

23
Q

which scan type can’t be used to examine the Esophagus

A

MRI cannot be used

24
Q

what scan can’t be used to examine the liver

A

highly metabolic- PET can’t be used

25
Q

which cancers can be diagnosed by CT imaging

A 
lung tumour 
pancreatic tumour 
renal tumour 
adrenal tumour 
retroperitoneal tumour 
brain tumour
26
Q

CT and staging of cancer

A

Assess local spread
e.g lymph nodes, adjacent organs
assess distant spread
e.g liver, lung, bone or brain metastases

27
Q

CT and staging of cancer

A

Assess local spread
e.g lymph nodes, adjacent organs
assess distant spread
e.g liver, lung, bone or brain metastases

28
Q

ALARA principle

A

as low as reasonably achievable- make sure examination is really necessary- avoid repeat

29
Q

MRI

A

powerful magnet
better
quality/resolution of image

30
Q

radio frequency reciever

A

receives

31
Q

water molecule in MRI scan

A

a very light molecule- takes longer to get back

32
Q

fat molecule in MRI scan

A

takes less time to be received

33
Q

disadvantages of MRI

A

noisy
claustrophobic
can’t image patients with pacemakers, aneurysm clips
image is motion dependent- need ot stay still!

34
Q

screening importance

A
  • diagnose disease at an earlier stage
  • cancer is easier to treat and most likely to be curable
  • NHS screening programme- breast, bowel and cervix
    no standardised screening for prostate- patient dependent
35
Q

WHO principles of screening

A

condition should be an important health population- breast, cervix and colon cancer v common in western population (japan- stomach) nee to have high uptake

there should be a latent stage of the disease- lung cancer doesn’t have latent stage- only 6 month max 2 years really. Should be visible in imaging before it becomes a cancer

should be a test or examination for the condition- breast mamogram etc
colon- fecal stool test

test should be acceptable to the population- something people will accept to go through

there should be a treatment for the condition- cancer shouldn’t be lethal, low morality for the cancer so patients may recover

facilites for diagnosis and treatment should be available

36
Q

Cancer staging- what does ‘stage’ refer to?

A

stage refers to the extent of your cancer, such as how large the tumor is, and if it has spread.

37
Q

TNM Staging System

A

T refers to the size and extent of the main tumor. The main tumor is usually called the primary tumor

N refers to the the number of nearby lymph nodes that have cancer

M refers to whether the cancer has metastasised. This means that the cancer has spread from the primary tumor to other parts of the body

38
Q

What stages are there?

A

5 stages: stage 0, I, II, III, IV
Stage 0= Abnormal cells are present but have not spread to nearby tissue.

Stage I, Stage II, and Stage III= Cancer is present. The higher the number, the larger the cancer tumor and the more it has spread into nearby tissues (in situ)

Stage IV= The cancer has spread to distant parts of the body.

39
Q

‘Localised’

A

Cancer is limited to the place where it started, with no sign that it has spread.

40
Q

genetic changes and cancer

A

Cancer is caused by certain changes to genes that control the way our cells function, especially how they grow and divide

Genes carry the instructions to make proteins, which do much of the work in our cells. Certain gene changes can cause cells to evade normal growth controls and become cancer.

41
Q

Source of genetic changes that can cause cancer?

A

inherited from our parents if the changes are present in germ cells (reproductive cells of the body)

result of errors that occur as cells divide or from exposure to carcinogenic substances that damage DNA, such as certain chemicals in tobacco smoke, and radiation, such as ultraviolet rays from the sun

42
Q

modalities of cancer therapy

A 
surgery
Radiation Therapy
Chemotherapy
Immunotherapy 
Targeted Therapy 
(targets the changes in cancer cells that help them grow, divide, and spread)
Hormone therapy 
Stem Cell Transplant 
(restore blood-forming stem cells in cancer patients who have had theirs destroyed by very high doses of chemotherapy or radiation therapy)
Precision Medicine
43
Q

TNM staging list

A

Tumour
T1-4

Nodes
N0-2

Metastasis
M0-1

44
Q

barium enema

A

enema is injected into rectum
examines colon
colon x-ray
Used in Chron’s disease

45
Q

are CT and PET scans combined?

A

yes they are often combined to detect cancerous tumours

46
Q

SPECT- what is it?

A

Single-photon emission computed tomography

gamma cameras rotate around area of interest

47
Q

What does PET use?

A

radionucleides that decay by positron emission

P.O.D own flashcards (34 decks)

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