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CT scan results

Xyz125
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Hi

I recently had my first CT scan following treatment  ( bowel resection and 6 months chemo) for stage 3 bowel cancer. I was told that there was no evidence of cancer but I would need an ultrasound scan as the CT scan was not showing my contraceptive coil and there was a concern that it had come out of my womb. I went for the ultrasound and they said the coil was in place exactly where it should be. My worries are that if the CT scan didn't pick up my coil what else is it not picking up? eg any recurrence of the cancer. I hope you can help explain why my coil did not show up on the scan and how good are CT scans at picking up cancer?

Thanks

  • Hello Xyz125,

    Thanks for getting in touch. My name is Helen, I’m one of the Cancer Information Nurses on the Macmillan Support Line.

    Welcome to the online community. I’ve noticed you have joined the bowel cancer forum and hope you are finding it a supportive and helpful group.

    You have expressed concern that the CT scan following your treatment for a bowel cancer didn’t pick up your contraceptive coil, and you are worried the scan may also have missed a recurrence of your cancer.

    Your query is a radiological one, and we don’t have access to radiologists here on Macmillan’s support line, but I will do my best to try to answer it.

    All intrauterine contraceptive devices are radio-opaque, which means they show up as a white object on both X-ray and CT images. So your coil should have been identifiable on the CT. However, it sounds like it was may have been more that case that its position was not verifiable by CT and therefore an ultrasound was needed.

    Ultrasounds are useful for examining internal organs and all the sources I have looked at – the Royal College of Radiotherapy, Radiopaedia and the National Library of Medicine - state that ultrasound is the preferred method for establishing the position of an intrauterine contraceptive device that may have migrated.

    In addition, I found some information in a US article discussing migrated or missing coils on the National Library of Medicine site that stated: If an IUD is present on a CT scan that was performed for indications other than the assessment of the IUD itself, it is important for the radiologist to evaluate for its proper position.

    It may be possible that this is your radiology department’s policy and that the reason they carried out an ultrasound was because, from what I can find, it’s considered to be the correct scanning technique for determining the location of a coil?

    You have asked how successful CT scans are for picking up cancer recurrence. Your cancer specialist will have followed the National Institute of Health and Care Excellence (NICE) guidance for your bowel cancer diagnosis, treatment and for your ongoing follow-up. NICE guidance is based on scientifically-evidenced information and provides a framework for best practice for UK clinicians.

    The NICE guidance for surveillance after bowel cancer treatment recommends CT scans, so your bowel cancer specialist is following national policy and best practice.

    I can understand that your recent experience has worried you and I wonder of you feel it would help to speak to your bowel cancer nurse specialist about your concerns? They will have access to your scans, to the radiologist who reported on them and to your consultant. It might help to get the situation clarified regarding the coil so you can feel you be confident about your results.

    Alternatively, you may wish to speak to us about your worries, you are most welcome to give us a call. The Macmillan Support Line offers practical, clinical, financial and emotional support. You can call us free from landlines and from most mobile phone networks* on 0808 808 00 00, 7 days a week, 8am – 8pm.

    I hope this information is useful. Please don’t hesitate to get back in contact by email, webchat or phone, if you need further information or support. 

    Best wishes, Helen

     Cancer Information Nurse Specialist 

     

     

    Ref HM/KR 

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