How accurate are CT scan results?

My mum's ovarian cancer condition worsened in Jan this year. This led to several bowel obstructions where my mum had non-stop vomiting of green bile. After starting chemo, her condition stabilised and for the last 3 weeks, had graduated from soft diet to normal diet. She passes gas and motion every day. Her CA-125 also dropped steadily from 3500+ to 500+. Today, she started the 3rd cycle of her chemo regime and before the start of the chemo, she had a CT scan and CA-125 test.

That is where all the confusion started. My mum's CA-125 showed a spike from 500 + to 900+. And to make matters worse, the CT-scan report stated there is no 'significant change' since the last CT-scan in Feb.

Both the doc and my mum are taken back. What happened in Feb when my mum took her CT scan? My mum had severe bowel blockage and was unable to pass gas or motion. She could not eat or drink anything and constantly vomit green bile every 30 minutes. My mum's stomach was so grossly distended and was as hard as a rock. The CT-scan indicated that there is a 15 cm peritoneal cake all over the intestines which the CT scan concluded caused the obstruction. And moderate ascities are present.

Fast forward to present situation. My mum could have a normal diet. She could pass gas (smelly ones) and motion every day naturally. Since the 15cm peritoneal cake is still there with no changes and coated over the whole length of small intestines, she should not be able to eat or have any food/water pass through. My mum's stomach looks normal and is tender. And when the doc knocks my mum's stomach, he couldn't hear/feel the 'moderate' ascities stated in the report.

So if what the current CT scan is true which stated that 15cm peritoneal is still there with no changes, my mum should be what she was going through in Feb and not being able to eat/drink. The CA-125 also seemed to back the CT scan results which showed a sharp spike.

Under normal circumstances, I would be upset with the CT scan and CA-125 results but the results seemed to be at odds with my mum's condition.

The doc still give the order ahead to start the same chemo regime and I am supposed to bring the Feb CT scans to him to compare. When I asked the doc whether the results indicated that the chemo regime is not working, he said that he wanted to wait for another week after the chemo to do a re-test of CA-125 and that radiologists 'sometimes see things differently'.

Anyone have similar experience?

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Well there are times that my Ong's don't take the CT scan as seriously. When There are reports or the nodules shrinking in the lung and liver that's not such a big deal - even though they shrunk from 1.3 to 1.1 and 1.0. Yet when a new one shows up or oone increases then they assume it's cancer spreading. I am awaiting the PET scna results now to confirm or deny the CT scan results.
I have mentioned this in the CA-125 discussion. Both Onc. don't use my CA-125 results as makers. They say that they are not accurate enough to use. I use them! When I see and increase I know something is up. When I had my recurrence in Sept.2011, the CA-125 was 3 then went to 9. Stayed at nine for a bit then went down. I was all happy when I saw my ob/onc in February because the CA-125 was at 4. He said that this was not a clear marker. I was very happy and I still use this for my own benefit. It's a bit of hope!
Now that there is a possibility that there is more cancer, my CA-125 has gone from4 to 6. Again this could be an indication that there is more cancer, but some great advice on this site from some wonderful women informed me that the CA-125 could go up due to infection. At the time of the test, and I still am battling a cold, and also have a surgical hnia that is causing me some pain. Who knows that could be the problem with the new lymph node and not cancer!
So Pink Tiusse, take the advice you get from these wonderful women, make notes and go with your mom to the doctors. Sometimes wen not only need to be our own advocates for these doctors but family members as well.....
Blessings,

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Radiologists interpret things the way they see them. Check to see whether it was the same radiologist reading the reports because they don't all call things the same way. You can also obtain the pictures and take them to your doctor who can compare the two himself or ask another Radiologist he is familiar with to look at them and give a second opinion. I used to have my CT scans done locally and took the reports (and a copy of my CT images) to my gyn/onc at another hospital. The delays in having one of their radiologists look at the films for interpretation caused me to just go there and have them done and my doc has his answers immediately.

Based on the way she feels, I would be comfortable moving forward with another chemo. It could be time for a change if the CA125 continues to rise but to stop the current treatment without being sure first, I wouldn't do that because what matters today is that she does feel better. I also don't think you always get a good reading on this type of caking in the peritoneum. Whatever happens, I hope Mom continues to feel okay, eat and toot away. It's just my opinion of course, you will probably hear others. Her doc will most likely know when it's time to jump ship. Best of luck to you all. I know it's hard.

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Not that much. CT scans give anatomic data, while PET scans give physiological data. Comparative studies report a slight statistical advantage for PET over CT or MRI. And the integrated PET/CT gives much more information to the physician. In fact, PET/CT scans can change the patient management (although still trial-and-error) up to 40% of the time.

http://cancerfocus.org/forum/showthread.php?t=3466

Best of luck!

Greg

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Thanks for giving me good advice. My mum had a bad fall and ended up breaking 2 teeth which needs a minor surgery to remove the remaining teeth and a deep cut along her jawbone (you could actually see the bone) a week ago (4 stitches). I am hoping that the shock to the system has affected her CA-125 although it seemed a long shot.

Crossing my finger that we would see better CA-125 results next week.

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On the blockage- I have had several episodes of partial bowel obstructions while in remission. They are do to adhesions

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