Who reads the CTs? - 1244954

Wed, 07/11/2012 - 21:02

Ok, I'm a little Type A and I over analyze everything!!! My mom's onc has 30 years of experience with lung CA and when she gets a CT scan, he reads it on the computer in the office and gives us the results there. Is that weird?? Doesn't he need an official read from the radiologist to confirm or deny NED or progression? Can I trust his results only?? My dad's previous oncologist just waited for the radiologist's report and never read his own scans. So, she had a good scan in June and me being paranoid is worried he might have missed something.

My husband tells me to relax and let a well-respected doctor at a large medical center DO his job and just take the good news for what it is! I, of course, want to pull the report and read it (like I usually do....then make myself worry with all the cover your butt stuff that radiologists have to write on there...PS. I'm also a RN which makes me more neurotic).


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Hi teresa567,

It's pretty easy to worry about CT results, regardless of who seems to be interpreting them. I would guess that when your onc reads the CT on the computer screen, he has also seen the radiologist's report, but is adding his own judgment based on his experience and knowledge of your mom's overall situation. Radiologists don't have all the background information on a patient, they simply read the scan, comparing it to previous scans if available. But they don't know anything about symptoms, etc. So in general I think it's a very good thing that your onc, with many years of experience (including reading CT scans), is adding his opinion to that of the radiologist.

Congratulations on the good scan result in June!

Forum Moderator


we have the radiologists report, but the onc always also looks at the report briefly and the scan in detail.

They also go through it with us, on the screen, comparing to a previous scan.

Its very helpful to see the scans side by side and see the progression (either positive or negative).

Dr West

I think it's helpful to get a perspective from both. I like to review the scans myself, but I'm not a professional radiologist and can certainly overlook some things, especially if I'm not looking for them (they're trained to be thorough about looking for changes in what was there before but also in checking for new things). At the same time, when they don't have the context, they can highlight things that really aren't clinically significant, misinterpret the cause of changes (not knowing someone had radiation to the chest could lead them to presume an infiltrate is infection or perhaps cancer, though it is more likely to be post-radiation inflammation, for instance), and the report tends to include a lot of CYA language that alarms a reader who doesn't know to automatically discount a lot of it. I do find it helpful to review the scans that may well sound like there's significant progression, when in fact the disease is far less worrisome when you actually look at it.

I really try to emphasize for my patients that the main question is whether, with the treatment we're doing, the disease is better, worse, or the same (combined with their tolerance of it). Most of us with reasonable experience can readily assess that even if we don't have the expertise to scrutinize and interpret every detail.

-Dr. West


Thanks so much for the replies. I am not going to go to medical records and drag myself thru the mud this time (and for a control freak, Type A lady...this is not an easy feat). BUT I am just going to enjoy a "good scan" and live in peace (till the next one in Jan). My mom is so incredibly happy with the results and I know if I read something a little different on the report and freak myself out, it will negatively affect her too.

Thanks again!!! Teresa