To review unusual CT findings in cancer patients that are not tumor-related.
To provide tips that help to correctly interpret them.
When faced with CT studies of cancer patients, radiologists fear 'missing' tumor-related lesions. However, misdiagnosis of lesions unrelated to the tumor as disease progression or recurrence can also impact negatively the diagnostic and therapeutic management of cancer patients.
Most findings in oncologic patients will be tumor related or treatment related, followed closely by infections or thrombosis. Some cases don´t fit in these boxes and are easy to mistake with cancer manifestations, unless we are aware of their less common but very characteristic findings.
Findings and procedure details
A. THE IMPORTANCE OF USING THE OPTIMAL TECHNIQUE FOR ACQUIRING AND READING THE IMAGES:
1-Dedicated CT protocol:Hypervascular metastases are more conspicuous in the arterial phase. In typically hypervascular tumors such as GIST, renal cell carcinoma, melanoma, neuroendocrine... consider acquiring also the arterial phase (Figure 1).
2-Optimized image review: choose the right window display. Review the soft tissues with a narrower window, which helps detect some lesions less conspicuous because of their density, especially in atypical locations that tend to go unnoticed: intramuscular metastases, bowel implants,...
Reading studies of cancer patients is challenging because of the complexity of the disease and the treatments. We have tried to help facing that challenge by reviewing some principles that are common to many areas of Radiology, providing useful tips and warning of possible pitfalls. Many mistakes may be prevented by internalizing these principles and using them when reading cancer studies. We have illustrated these tips with examples of cancer cases.
Personal information and conflict of interest
A. Viteri Jusué; Bilbao/ES - nothing to disclose A. Ostapenko; Vitoria/ES - nothing to disclose A. Iturralde Garriz; Vitoria/ES - nothing to disclose N. Alonso Ordás; Vitoria/ES - nothing to disclose B. Melero Romero; Alicante/ES - nothing to disclose