Topic: Imaging - simplified explanation

C-T (CAT) Scans - computed or computerized tomography.
Can show precise location of tumor, defined shape, solid or hollow;  provides clues to a cancerous tumor but not as concrete as biopsy. 
Not reliable in identifying tumors less than 2 cm in size.

MRI (Magnetic Resonance Imaging) Scans -  In many tissues, the image and detail are clearer than those with an MRI than a CT scan.
For some tissues, MRI image is less clear than CT. Difficult to distinguish between Inflammation and scar tissue.

PET (Positron Emission Tomography) Scans - picks up cancer activity at a very small level. 
Image not as clear as CT and MRI, inflammation can obscure other activities on scan and localizing exact location of tumor.  Best suited for higher grade tumors, metastasis.
Some insurance carriers won't cover cost of PET Scan.

CAT/PET Combo Scans - wave of the future,  allows for anatomical detail of the CT and detection of small nodules of cancer cells by PET.  Not yet widely available in many hospitals.
Insurance coverage:  don't know.


Re: Imaging - simplified explanation

Thanks for that Marion. Some more on scans - … scans.aspx

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Any advice or comments I give are based on personal experiences and knowledge and are my opinions only, they are not to be substituted for professional medical advice. Please seek professional advice from a qualified doctor or medical professional.

Re: Imaging - simplified explanation

In reviewing your 2016 Highlights Videos, I enjoyed with the one with Dr. Choti and Dr. Chapman and I agree 100% that primary doctors and GI doctors need to become more aware of the procedures for diagnosing Cholangiocarcinoma in order to not disqualify their patients who may be eligible for liver transplant with invasive biopsies and procedures.

I am at a crossing point as my beloved father is schedule for an ERCP in order to further explore and to relieve his bile blockage (jaundice). I will be asking the GI doctor doing the procedure about how he plans to brush for sample in order to obtain cells while not disturbing whatever may be there?

My red flags are up when Dr. Champan stated most of his inquiries come from patients themselves as opposed to doctors and that before ERCP's are done and/or any other biopsies a game plan needs to be in place in case the patient is a candidate for liver transplant. How do we as patients, achieve this???? My father presented these symptoms two weeks ago and he was given an MRI (without contrast) that didn't find any masses or tumors but of course something is blocking and giving him jaundice and there is no other option but to go in.....I hope this procedure doesn't disqualify him from further interventions.

I was also asked if he had a PetScan done because it will show doctors if there are tumors somewhere else in his body. Who orders what? I am at a loss, the Primary referred him to the GI based on bloodwork and symptoms, the GI referred us to UC San Diego for ERCP based on his symptoms.

Do we as patients have a say what diagnostic tests we want? MRI vs. MRI with contrast or or PetScan. And if CC is suspected and there is no blockage can GI doctors just order PetScans instead of ERCP??

What is your experience of most patients? and those of trends in imaging for diagnosing and staging.