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What causes differences in reading of CAT Scan and MRI imaging?
I had a Cat Scan 9/5 that first identified the cancer. Then I had an MRI 11/19/24 and then a Cat Scan 12/3/2024.
I am wondering how much difference is due to who is doing the measuring or difference in equipment. The MRI measurement did not show the growth of the original mass from 4 x 3.1cm to 4.5 x 3.2cm as the latest cat scan did. The MRI was read as 4.2 x 3.1cm. Rounding error I would think from the original scan.
The most recent cat scan also did not reference the lesion seen in the 9/5 scan on image 84 in the right lobe. I would have expected them to say they no longer saw it or reference it had not changed.
I also am not sure when the reading says he thinks the lesions are stable. How is that determined by reading the scans?
I am not sure whether to believe the scan or the MRI. One indicating there was growth from 4.0 to 4.5cm and one that showed a 4.1 vs 4.0cm which I would think could easily be difference of who did the reading.
Appreciate the experience of others. Thanks.
12/3/2024 Cat Scan;
Liver: There has been increased size of metastatic disease to the liver. For example, the largest mass in the liver is located in the anterior liver segment 4! measuring 4.5 x 3.2 cm. Previously measuring 4.0 x 3.1cm.
MRI 11/19/24
Liver: Multiple metastatic lesions in the liver which are best seen on series 502, diffusion-weighted imaging. The largest lesion in segment IVa measures 4.2 x 3.1cm on image 24 series 801. The second largest lesion in segment VIII measures 1.5 cm on image 31 of series 601. There are 6 additional lesions annotated on diffusion-weighted series 502. There is a T2 hypertense focus on image 25 or series 502 and image 21 of series 801 which is favored to be a vascular structure, as can be best seen on coronal series 701, image 45.
Cat Scan 9/5/2024
There is a low density mass in the interior of the left lobe segment 4A measuring 4.0 x 3.1 cm on image 92. There are additional low-density lesions noted throughout the liver, many of which are stable. There is also a new low-density lesion in the anterior right lobe the liver, segment 8 measuring 0.8 x 0.9 cm on image 84..
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HugInterested in more discussions like this? Go to the Neuroendocrine Tumors (NETs) Support Group.
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I have had Scans read wrong
I think private places don’t really know what they are looking for
I always use to get a copy of my scans when i went to a private place because my liver surgeon was great at pulling them up in front of me and showing me comparisons
Unfortunately that ended when the cancer returned and I needed to see an oncologist
Long story short
My first NET oncologist was great but I had to travel and lanreotide gave me sever diarrhea immediately
So I switched to another NET oncologist that put me on Ocreotide at a cancer center very close to home
Perfect situation
Be careful what you wish for
9 months of treatments and I was getting sicker even though she was telling me the only thing happening was my liver tumors were multiplying so I did a blan embolization
She reviewed my scans in front of me and totally missed the cancer had spread to my spine
Time is so important with this disease
I didn’t know she had missed it until I went back to my original NET oncologist he sent out my scans to be read by a cancer radiologist
I was mortified
I had another Blan embolization to the other side
Moral to the story
Don’t believe what is on the reports unless you have a great radiologist reading your scans
Get copies of all your scans keep them and bring them with you so they can be looked at by whomever you go to
Also I just did an MRI which showed no cancer in my cervical spine but the PET scan did
Remember PET scans pick up the cancer MRIs show the growth
It’s very frustrating
I wish you the best of luck
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Hug
6 ReactionsMRI’s are more accurate than CT scans for best visualization and measuring of liver tumors. For that reason? MRI is the preferred imaging for monitoring liver tumors specifically
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1 ReactionI can't have MRIs, so I only get PET scans. I also don't worry about millimeters. They can change frequently. I primarily focus on centimeters.
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2 ReactionsThanks for sharing
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Thanks for sharing. I have also read that MRI's are preferred.
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1 ReactionThanks for taking the time to share your journey and words of wisdom on what you have learned. Best to you as you continue your treatment.
You’re welcome! Typically the next step would be to have a gallium or copper pet scan. These scans are specifically for nets and will help determine a couple of things. It will determine if your tumors have the necessary receptors to be a candidate for other treatments such as PRRT (which is quickly becoming a standard treatment) and will also show tumors anywhere else in the body that are otherwise undetectable.
Are you seeing a net specialist?
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2 ReactionsI am seeing Dr Daniel Halperin, a NETS specialist, who was at MD Anderson and is now at Emory in Atlanta. I have had the Dotatate Pet scan. The liver is the only place that lit up. Decided that the likely origin was the GI Track and since the treatment is the same for the liver and GI Track, Dr decided there was no reason to pursue finding the origin. My tumors are non-functioning so do not produce hormones or give me symptoms.
I took a deep breath and asked for a second opinion when the 2022 results of my PET scan with Cu 64 Dotatate showed hilar and mediastinal lymph nodes with “Dotatate” uptake according to the technician and my oncologist noted that signified likely metastatic neuroendocrine cancer. I had no symptoms of metastatic cancer (neuroendocrine intestinal tumor & several nearby malignant lymph nodes removed in Jul 2022), my Chromogranin A blood tests were in the normal range, so I asked that the PET results be sent to Dana Farber Cancer Center in Boston under their second opinion program. They disagreed with the finding of metastatic cancer and recommended another PET in 3 months. I did that and the results were the same - I have been symptom free since. I know this is different from the MRI/CAT scan topic but if in doubt about tests, a second opinion can be important. In my case I would have started Chemotherapy for nothing.
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2 ReactionsYour question was about comparing measurements between CTs and MRIs? So in my experience that really works best with comparing apples to apples. I agree with Lindabees comment about future PETs. Typically the next step would come when you get another gallium or copper dotatate pet scan. Then you can compare NETs tumor/cancer growth over time the best way I suspect. That's what my doctors are doing now. I take a picture with my phone of each front view PET scan and compare them. I've had 3 Pet scans, 2 MRIs, and countless CTs. Just like Turkey mentioned, We don't seem to be worried about a mm here or there. Pet scan comparison: 7 months ago I had a mass measure 2.0 cm x 2.5 cm, last month it measures 2.0cm x 2.7 cm. Not doing anything about that. I have no symptoms. Doc said "what do you think"? I said "let it ride". He agreed. All Pets from here on out it seems for me every 6 months. Now for clarity, you do get a low res CT anytime you get a PET for mapping.