Second CT scan today!

Posted by bronchiectasaurus @bronchiectasaurus, May 4 3:36pm

I got my second chest CT scan today, exactly one year after my first.

2025 scan analyzer’s “impression”:
“1. Mild bilateral bronchiectasis.
2. There are several subcentimeter pulmonary nodules and groundglass opacity. Recommend follow-up in 12 months.”

2026 (today’s) “impression”:
“1.No suspicious pulmonary nodules are identified.
2.Calcified granulomas are present.”

These scans were analyzed and signed by different people. My med system has no bronchiectasis specialists and the only reason they paid any attention to my first scan was the nodules and granulomas. But last year I was coughing so much I could barely talk or eat, for 2 months, so since that diagnosis I have been nebbing saline and masking and so on and feeling much better.

I meet with a new pulmonary specialist later this month. I don’t expect them to know much about bronchiectasis but will ask anyway. I will ask to compare images from both scans.

I honestly don’t care much about the nodules and granulomas, as they weren’t causing the paroxysmal coughs or taking away my voice and appetite. I wish someone in my system knew about bronchiectasis so I wouldn’t have to rely solely on networks and forums and webinars and friends of friends who have it, although I am very grateful for all those.

Anyone else get rather different descriptions of sequential scans?

Interested in more discussions like this? Go to the MAC & Bronchiectasis Support Group.

cwal | @cwal | May 5 7:07am

Different readings and interpretations of CT scans by radiologists are very common. They work "in the world of shadows and images on a screen" and although they are experts in that field, they can't see the whole clinical picture of a patient. That's why it is vital to have a pulmonologist that specializes in the treatment of BE and MAC. They know and see the "whole picture" of the patient clinically and can provide treatment that way.

scoop | @scoop | May 5 7:27am

And radiologists favorite tree is the hedge!

Sue, Volunteer Mentor | @sueinmn | May 5 9:57am

@bronchiectasaurus Ah that's a good question "Anyone else get rather different descriptions of sequential scans?"

Always curious, I tend to ask a lot of questions to the technicians when I have tests done, it is amazing what you can learn about how our complex modern medical system works. I had a long talk with the radiology tech after my last scan (his next patient cancelled) about the differences between radiology reports. This was at a major hospital with both heart and cancer centers. Here was the explanation (no quotation marks because I am paraphrasing from months ago.)

When you see the analyzer's impression on your portal, you are seeing a very preliminary summary, what the doctor sees is significantly different. Standards for this report vary widely from one facility to another.
Radiologists are trained to report all "findings" on a scan, concentrating on whatever details the physician puts in their order for the test.
Some are better than others at recognizing details and their significance.
Many, but not all facilities use a "team " approach to reviewing scans, with one or more docs contributing to the report. Some facilities also run the scan through an AI tool as well, but AI does not write the report - just points out details to the radiologist.
The pulmonologist or other treating physician is responsible for using the complete report, together with your medical records, to make a diagnosis or chart your progress and communicate the results to you.

Does this give you a better picture of how such different summaries can land on your patient portal?

bayarea58 | @bayarea58 | May 5 12:40pm

Unfortunately I have had very negative experiences with my CT interpretations. 4 CTs all labeled “stable” when in fact I had progressive cavitary disease. That was a big wake up call. I now have an NTM specialist, actually two, and I rely on them to tell me what they see. But I can tell you that every single medical professional has told me something different about what they see on my CTs. I have a lot going on, which certainly makes it more complicated, but it’s not a Rorschach test.

gerry26 | @gerry26 | May 5 9:00pm

The only discussion after my first CT scan was about the cloudy section in my left lung under the area of my cancer radiation, and they did a broncoscopy (aka water boarding!) to clear it. No mention of bronchiectasis but lungs are scarred. Choking cough continued in spite of nebs and inhalers. Six months later 2nd CT showed a hematoma at my incision site. I insisted on seeing the scan and that's when bronchiectasis came up and how it can make the lung scarring worse and possibly shorten my life span.