WlwG Management Protocols Flashcards
Adrenals: Non-adrenal CT, <1cm
NFU
All <1cm or non-enhancing = No further scan
1-4cm <10HU on plain = No follow up
Otherwise, 1-2 cm and no cancer history = 12 month CT adrenal
Otherwise = Early CT adrenal
Adrenals: Non-adrenal CT, non-enhancing
NFU
All <1cm or non-enhancing = No further scan
1-4cm <10HU on plain = No follow up
Otherwise, 1-2 cm and no cancer history = 12 month CT adrenal
Otherwise = Early CT adrenal
Adrenals: Non-adrenal CT, 1-4 cm, <10HU on plain
NFU
All <1cm or non-enhancing = No further scan
1-4cm <10HU on plain = No follow up
Otherwise, 1-2 cm and no cancer history = 12 month CT adrenal
Otherwise = Early CT adrenal
Adrenals: Non-adrenal CT: 1-2 cm, no cancer history, >10HU on plain
12 month CT adrenal
All <1cm or non-enhancing = No further scan
1-4cm <10HU on plain = No follow up
Otherwise, 1-2 cm and no cancer history = 12 month CT adrenal
Otherwise = Early CT adrenal
Adrenals: Non-adrenal CT: 2+cm or >10HU on plain
Early CT adrenal
All <1cm or non-enhancing = No further scan
1-4cm <10HU on plain = No follow up
Otherwise, 1-2 cm and no cancer history = 12 month CT adrenal
Otherwise = Early CT adrenal
Adrenals: CT Adrenals: <1cm
NFU
Adrenals: CT Adrenals: Non-enhancing
NFU
Adrenals: CT Adrenals: 1+cm, <-10HU on plain
Myelolipoma, NFU
Adrenals: CT Adrenals: 1+cm, <10HU on plain
Lipid rich adenoma, NFU
Adrenals: CT Adrenals: 1+cm, >10HU on plain, high washout
Lipid poor adenoma, NFU
Adrenals: CT Adrenals: 1-4 cm, >10HU on plain, low washout
Indeterminate, close follow up, consider Bx/PET
Adrenals: CT Adrenals: 4+cm, no cancer hx
Adreno-Cortical Ca, resect
Adrenals: CT Adrenals: 4+cm, cancer hx
Mets, Bx/PET
Adrenals: CT Adrenals: HU>120
Pheochromocytoma
Adrenals: Follow up CT Adrenals: 1-4cm, stable 1 year, no features of functional adenoma/pheo
NFU
Adrenals: Follow up CT Adrenals: 1-4cm, new or enlarging, no cancer hx
Follow up CT, consider resection
Adrenals: Follow up CT Adrenals: 1-4cm, new or enlarging, cancer hx
Mets, Bx/PET
BIRADS: 0
Insufficient scan = do additional views/US
(“RNB 2BC Really normal but to be confirmed” = Repeat, Normal, Benign, 2 year F/U, Biopsy, Cancer)
BIRADS: 1
Completely normal breast
(“RNB 2BC Really normal but to be confirmed” = Repeat, Normal, Benign, 2 year F/U, Biopsy, Cancer)
BIRADS: 2
Complete benign findings (fatty lesion/cyst)
(“RNB 2BC Really normal but to be confirmed” = Repeat, Normal, Benign, 2 year F/U, Biopsy, Cancer)
BIRADS: 3
Benign but 2 years of short-interval follow up (fibroadenoma/cluster of calcs, <2% chance of malignancy)
(“RNB 2BC Really normal but to be confirmed” = Repeat, Normal, Benign, 2 year F/U, Biopsy, Cancer)
BIRADS: 4
BIOPSY as unsure benign/malignant (30% chance of malignancy)
(“RNB 2BC Really normal but to be confirmed” = Repeat, Normal, Benign, 2 year F/U, Biopsy, Cancer)
BIRADS: 5
BIOPSY as likely cancer (95+% chance of malignancy)
(“RNB 2BC Really normal but to be confirmed” = Repeat, Normal, Benign, 2 year F/U, Biopsy, Cancer)
NIRADS for post-treatment H&N cancer: When to do CT/PET?
CT neck and PET-CT at 3 months post treatment
CT neck and chest or PET-CT at 9 months post treatment (6 months after prior scan)
NIRADS for post-treatment H&N cancer: 0
Incomplete, no prior imaging for comparison