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Principles of Disease > Imaging in cancer > Flashcards

Imaging in cancer Flashcards

1
Q

What imaging methods can be used to diagnose and stage cancer

A 
Plain radiographs
Barium studies
CT
MRI
PET
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2
Q

What is barium sulphate

A

A radio-opaque contrast used for outlining the gastro-intestinal tract

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3
Q

How does barium sulphate in barium studies work

A

The high atomic number of barium absorbs more x-ray photons than surrounding tissue

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4
Q

What colour does barium appear on radiographs

A

White

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5
Q

What does a barium swallow and meal show

A

Oesophagus
Stomach
Duodenum

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6
Q

What does a barium follow-through (small bowel study) show

A

Small bowel

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7
Q

What does a barium enema show

A

Large bowel

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8
Q

How does a patient prepare for a barium meal and follow-through

A

Fast for 4-6 hours

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9
Q

How does a patient prepare for a barium enema

A

Low residue diet for 48 hours

Bowel cleansing with picolax

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10
Q

What is a CT scan

A

When X-Rays produce a digitay image of a slice of tissue, normally in an axial plane, using computing to create the image

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11
Q

What type of cross sectional imaging is used for the initial diagnosis and staging of cancer

A

CT
MRI
PET

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12
Q

What can CT, MRI and PET also be used to identify

A

Response to treatment
Evaluation of mass after treatment
Complications of treatment
Concerns for replase

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13
Q

What is a hounsfield unit

A

Attenuation values of voxels are expressed as a CT number which relates the attenuation value to that of water
Ranges from +3000 (bone) to -1000 (air).

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14
Q

Can CT images be reconstructed

A

Yes

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15
Q

What type of CT contrast agents are there

A

Oral

Intravenous

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16
Q

What is an oral CT contrast agent

A

A dilute iodine based contrast (gastrografin) which can be given to outline the gastrointestinal tract

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17
Q

What is an intravenous CT contrast agent

A

An iodine based contrast (omnipaque) inject into the veins to show blood vessels or the vascularity of different tissues

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18
Q

How can imaging help in diagnosis and staging

A 
It shows the: 
Position of the tumour
Depth of penetration of the tumour
Relationship to adjacent structures
Involvement of regional lymph nodes
Presence of distant metastases
19
Q

What types of tumours do CT scans help diagnose

A 
Lung tumours
Pancreatic tumour
Renal tumours 
Adrenal tumours
Retroperitoneal tumours
Brain tumours
20
Q

How do CT scans help stage cancers

A

They assess the local spread (e.g. lymph nodes, adjacent organs) and assess the distant spread (e.g. liver, lung, bone or brain metastases)

21
Q

What type of cancers are imaged using MRI’s

A 
Brain
Spinal cord
Head and Neck
Liver
Rectum and anal
Kidney
Bladder
Prostate
Ovary
Cervix, vagina, vulva
Uterus
Lymphoma - CNS/MSK
Musculoskeletal
22
Q

How can CT scans monitor cancer

A

By making 2D measurement

23
Q

What do CT scans monitor in cancer

A

Response to treatment
Relapse
Progression of disease

24
Q

How many mSv is a patient exposed to from a chest CT

A

8

25
Q

How many mSv is a patient exposed to from an abdomen CT

A

10

26
Q

How many mSv is a patient exposed to from a pelivs CT

A

10

27
Q

What is 10 mSv equivalent to

A

500 return flights from Manchester to Malaga

4 years in Aberdeen

28
Q

What does the ALARA stand for

A

As low as reasonably achievable

29
Q

What is the ALARA principle

A

It ensures whether the examination is necessary

There must be adequate clinical information for appropriate protocol and repeat examinations should be avoid

30
Q

What does CT stand for

A

Computed tomograph

31
Q

What does MRI stand for

A

Magnetic resonance imaging

32
Q

How does an MRI scan work

A

Human body made up of various elements such as: hydrogen, oxygen, phosphorous etc.
The strong magnetic field aligns the protons (H+) in the body in one direction
A radiofrequency pulse will displace protons
The images are created by displaying the time taken for protons to ‘relax’ back to the original alignment

33
Q

State the indications for an MRI scan

A 
The excellent bone soft tissue detail
If the vessels can be seen
Brain, spine and musculoskeletal studies
Abdomen and pelvis studies
Cardiac imaging
34
Q

What are the contraindications of an MRI scan

A

It is claustrophobic and noisy
The motion artefact
It cannot image patients with pacemakers, aneurysm clips etc.

35
Q

Name a MRI specific contrast agent

A

Gadolinium DTPA

36
Q

What is gadolinium DTPA

A

An intravenous contrast medium that causes changes in the local magnetic field, so alters the tissue signal

37
Q

Name 3 NHS screening programmes available

A

Breast
Bowel
Cervical

38
Q

What are the WHO principles of screening

A
  • Condition should be an important health problem
  • There should be a latent stage of the disease
  • There should be a test or examination for the conditions
  • Test should be acceptable to the population
    There should be treatment for the condition
  • Facilities for diagnosis and treatment should be avaliable
39
Q

Which NHS screening programmes involve imaging

A

Breast
Ovarian
Lung cancer

40
Q

What type of screening is used for breast cancer

A

Mammography

41
Q

What type of screening is used for ovarian cancer

A

TVUS (research)

42
Q

What type of screening is used for lung cancer

A

Spiral CT (research)

43
Q

What are the advantages of screening

A

Detects disease at an early stage where treatment can alter outcome
Test causes no harm
Test has high sensitivity and specificty
Benefits the individual and the population

44
Q

What are the disadvantages to screening

A

Cost

Exposure to radiation

Principles of Disease (41 decks)

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