Image and endoscopic exams are important tools supporting the clinical hypothesis. They increase the sensibility and specificity of the physical exam, leading to a more accurate diagnosis. When browsing the icons below you will better understand how physicians work with image and endoscopic investigative methods.
Although physical exam of the patient is an essential step in cancer detection, there are some situations, which the tumor could only be assessed using special devices. They include endoscopic methods and imaging techniques. Both are described in this tutorial section. Browse over them for more information.
The image diagnostic methods include X-ray, ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI). These methods enable the detection of anatomic defects. Some of these methods use contrast media, which are administered intravenously, allowing the enhancement of morphologic abnormalities, further assisting in tumor diagnosis. A nuclear medicine device (scintigraphy) uses radioisotopes, which could detect metabolic changes, observed during disease process. More recently, PET-CT was introduced for cancer diagnosis and staging. The method combines the positron emission scan with computed tomography. PET-CT uses a radioactive contrast medium called flourodeoxyglucose, which is taken up by highly active cells, increasing tumor detection. The results are measured in standardized uptake values (SUV), which quantify the cellular proliferation rate. The method allows the identification of the size, shape and location of the tumor, as well as its metabolic activity.
They are diagnostic methods that use flexible fiber optic devices, allowing shooting and photographing the changes observed in body cavities. Previous patient sedation supports an exam with minimal discomfort. In esophagogastroduodenoscopy, the device is introduced through the patient mouth, allowing a view in real time of the esophagus, stomach and duodenum. In colonoscopy, the device is inserted into the rectum and progresses throughout the large intestine. It is an essential exam in the prevention and diagnosis of colon and rectal cancer. Bronchoscopy is a fiber optic device, which examines the respiratory tract and is one of the main methods used to diagnose lung cancer. Cystoscopy allows for the diagnosis of bladder cancer. Using endoscopic exams, the physicians are able to collect samples (biopsies) sending them to the pathology lab.
The endoscopic and image tests are important aids for cancer diagnosis. They are always followed by a written report signed by the doctor who performed the exam. Usually, the physician selects the most illustrative data in an attempt to better document the findings. In CT scan, the written report is sustained by the most representative images. Films or photographs are attached to the written endoscopic report, improving cancer diagnostic evidences.
The attending physician is responsible for the definitive diagnosis of cancer. It should be based on patient history and physical exam, imaging, endoscopy and pathologic reports. The material used for pathologic diagnosis, which is composed by the paraffin's embedded block and the slides should be stored under the responsibility of the pathology lab. However, they belong to the patient and could be required for further review, at any time. The image and endoscopic visual materials delivered to the patient should be carefully kept in a secure and organized file, since they represent irreplaceable documents, which could be necessary for further comparative reviews.