CONTRAST?, or NO CONTRAST?... That is the question...

During my concurrent chemo/radiation treatment in August, I had a CT scan WITH CONTRAST that picked up some additional "opacities" and potential embolisms that we had not seen on prior scans. After my chemo/rad. treatment was completed we did a follow up scan in October WITHOUT CONTRAST that showed most of the opacities and nodes as "resolved" or "clear".

I was ecstatic to hear that they could not find anything on the second scan that suggested that there was still a mass or opacities to worry about, but my concern is that if I had the same scan with contrast it might pick some of those same "issues". I asked the Onc who said he gets a more definitive picture without contrast, while other Doctor friends said they weren't sure which would be best.

So, I'm curious to hear from others who are doing scans every 3 or 6 months to monitor their tumor size or NED status:
1. Are your scans WITH or WITHOUT contrast?
2. Does your Onc have a reason for using (or not using) contrast?
3. Do you also have a PET or MRI at the same time to confirm CT findings?

Thanks for your input,
Mook

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With contrast!! Nope no PET

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MM,

"Gets a more definitive picture w/o contrast"? Is this yahoo board certified? Was he sleeping when they covered CT's in Residency?
Every single scan I've had done was w/contrast, prolly 50 in the past eleven tears.
Does he have a reason for not using contrast? My best guess? He forgot to check the box for contrast on the referral.
MRIs aren't used on the chest. I had one combined CT/PET of the abdomen to get a clearer view of an adrenal gland about 7-8 years ago.
No other PETs ever done.
Might be time for a second opinion from an Onc that doesn't have a sleeping disorder.

G

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Mook,
In June I thought I had vertigo and had an MRI which showed a brain tumor that was quite large and had to be removed immediately. I soon found out that it came from my lungs (I am a non-smoker).
1. my scans are like yours -Sept. I had an MRI which showed no leisons in the brain on the same day with ct with dye which showed 4 lung tumors that had shrunk (yippee for me). This was done a day before the scheduled next chemo blast of Alimta and Carbplatin. Carbplatin is so tough on your system that my doctor wanted to make sure it worked.
I like you, had another c-scan and was surprised (after fasting) that it was without contrast. I have a copy in front of me (do you ask for your copies and also you blood results? My Tumor oncologist gives me the scans and the day hospital has been giving me the blood results). What I wanted to share with you is that I can see opacities (floating) in all three scans, equally well. Is this helpful to you?
2. I will ask my doctor when I go next and I always see him before my chemo (do you see yours prior to your 3 week chemo?)
3. PETs have been done separately. You drink the glucose (remember the scan with contract is fasting and then you drink the 2 glasses of nasty juice). I know my doctor said that you can not see as clearly the details on a PET but can see hot spots which indicate if your tumors have spread elsewhere outside the lungs or whereever you have yours. He explained to me the hot spots that always show up and explained when to worry about these.
On the MRI - only once at the same time. My doctor explained that if your c-scan indicates nothing is growing and that the tumors are responding well to the chemo, that the MRI would be a waste at that time because if it primary in the lung and isn't spreading, then the MRI would not show anything at that time. Wil I be getting an MRI? Yes probably in another month 1/2.
Oh and the last scan without contrast.... you can see clearly my largest tumor which was on the wall and which my doctor feels was the mother feeder to the brain, has now pulled away and shows atrophy. Again another yippee for me! I will be curious to learn more on what your doctors say. Good luck! Cindy

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MC,

How was your brain met treated? They have not done F/U brain MRI's since treatment?
Your doc is telling you that if the chest CT is OK, you don't need a brain MRI?

G

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Yes I have had 3 since June; the last in Sept. and my brain oncologist came running to me in the hall as I was headed in to chemo and said there was absolutely no mets visble. I believe that was another reason that I didn't need an MRI at this particular time. I will have a ct with dye after my 6th Carboplatin/ Alimta treatment and before changing to Alimta and possibly something else. Stay tuned. Guess each of us have something a wee bit different and we pray that they all guess right for us. So far, so good. And if I don't explain mine well, blame in on the chemo brain!

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How was the brain met treated?

G

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I have always had contrast except this last time.
I had a wheezy chest and it was for once they decided against it because of my wheezing.
I asked about it, and they said it still showed if cancer was present but just did not show the vessels as well.
My own doctor said he does not always require the contrast where my first oncologist who has since retired, ALWAYS used it.
This last scan I had kind of scared me, because the techs told me that when you are wheezing too much, it could cause an allergic reaction, just what I wanted to hear.>
I am always wheezing...

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If I have been getting chemo without, if I am on a chemo break with

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Always with contrast.
Charlene

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I am at 6 month intervals. I have been having the CT/PET combination since it is available. I've had that the last 3 times I think. The Ct part is done BOTH with and without contrast. Even when I just had the CT scan it was both with and without contrast.

She has never said why she does it this way.

I had another doc in the same group, before this one, he did it the same way both with and without contrast.

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My tumor was found very early by accident on a CT scan with NO contrast. They were checking for pneumonia. I can not have any kind of dye or contrast for any scan as am severely allergic to it all so they all have to be done without contrast. My onc. has ordered a pet scan for my 4 month post op for a week from today. I know she shook her head and told me she couldn' t believe they found my tumor when they did how they did .... that i WAS SO LUCKY. I know I was ....

God Bless!

~ Patty

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My husband's CT scans have always been done w/out contrast - except for the first. The first was prescribed by our internist in NJ who does not specialize in oncology. My husband took it to NY Presbyterian (Cornell) where the surgeon who did the biopsy (well known thoracic surgeon) found the first CT scan unacceptable and ordered a CT scan without contrast. My husband's oncologist (from NY Presbyterian -Columbia and now LIj) who specializes in lung cancer, always has ordered CT scans without contrast. This is no mistake. The scans are also done at a well-known radiology practice in NYC (with doctors all trained at Cornell) and the radiologist there have never commented about the scans being done without contrast. My assumption is that this is the standard for this disease. Other forms of cancer are treated with their own testing formats.

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Cat scan every three months - with contrast - and drinking that awful white liquid before the test.

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Cat scan every three months - with contrast - and drinking that awful white liquid before the test.

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I had mine without contrast. However, the radiologist who read the results (NED) recommended in his report to do the next one with contrast. Only had 1 PET and that was prior to suregery. The PET basiclally showed them the tumor had not spread to any lymph nodes or other organs nor had it come from anywhere else - whew! Had ULL removed in May 09 and have had one follow-up x-ray and one CT scan - pulmonolgist told me I can do CT annually now which makes me an extremely happy camper. I was stage 1A - very very lucky. Also NO treatment!
Tennis1

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