Diagnostics

Role of Diagnostic tests ?

Diagnostic test can be imaging of the body or test done on tissues from the cancer cells or blood. They aim

  • To look at suspicious areas that might be cancer.
  • To look for extent of cancer spread.
  • To determine if patient is responding to treatment.
  • To look for possible signs of cancer coming back after treatment.

Chest x-ray

Often the first test your doctor will do to look for any abnormal areas in the lungs though it will miss out small size lesion.

Computed Tomography (CT) Scan

  • A CT scan combines many x-rays to make detailed cross-sectional images of the body.
  • A CT scan is more accurate to show tumors . It show size, shape, and position of any tumors and can help find enlarged lymph nodes that might contain cancer cells. In some cases CT abdomen is done to look for abnormal areas in the adrenal glands, liver, and other organs that might be from the spread of primary site of cancer.
  • The CT scan can help to determine whether the disease is surgically removable.

CT guided Trucut biopsy: In lung cancer CT scan can be used to guide a biopsy needle precisely into the lung or organs in the chest.

Magnetic Resonance Imaging (MRI) Scan

MRI scans with no radiation exposure show detailed images of soft tissues in the body and help in diagnosing metastatic disease in the brain which can be missed on CT and PET scan

Positron Emission Tomography (PET) Scan and PET / CT Scan

PET scan is a functional imaging system based on the concept that cancer cells grow faster and have higher metabolic activity which is picked on the PET scanner.

For a PET scan, you are injected with a slightly radioactive form of sugar, which collects mainly in cancer cells because of higher energy requiremnt. A special camera is then used to create a picture of areas of radioactivity in the body.

This test to see if the cancer has spread to lymph nodes or other organs, which can help determine your treatment options.

PET/CT scan: Some machines can do both a PET scan and a CT scan at the same time. This lets the doctor compare areas of higher radioactivity on the PET scan with the more detailed appearance of that area on the CT scan. The PET scan is specially useful for staging lung and oesophagus cancer.

DOTANOC Scan

A type of PET scan specific for carcinoid tumors / Neuroendocrine diseases.

Bone scan

A bone scan show if a cancer has spread to the bones. This test is done mainly when there is reason to think the cancer may have spread to the bones (because of symptoms such as bone pain).

Thoracentesis

Fluid around lungs (called a pleural effusion ), is removed under image guidance and checked for cancer cells.it also done to relieve symptoms

Bronchoscopy

  • Bronchoscope is a lighted, flexible fiber-optic tube.
  • Bronchoscopy can find tumors or blockages in the airways of the lungs. It is used to take biopsy.

EBUS (endobronchial ultrasound) and FNA

Ultrasoung guided bronchoscopy FNA biopsy of the mediastinal lymph nodes for staging of lung cancer. The Transtracheal FNA or transbronchial FNA is done by passing the needle through the wall of the trachea (windpipe) or bronchi (the large airways leading into the lungs) directed to the lymph nodes.

Barium swallow

A thick, chalky liquid called barium is swallowed to coat the walls of the esophagus and shows any abnormal area. serial X-rays of the esophagus are then taken, that includes the stomach and part of the intestine, called an upper gastrointestinal (GI) series.

This test can also be used to diagnose one of the more serious complications of esophageal cancer called a tracheo-esophageal fistula.

UGI Endoscopy

An UGI endoscope is a flexible, narrow tube with a video camera and a light source and is used to look inside the oesophagus or food pipe.It helps in localisation and biopsy of suspected lesion in esophageal cancer.

Endoscopic Ultrasound / EUS

At the time of UGI endoscopy, ultrasound is used to detect depth of esophagus tumour and if nearby lymph nodes are involved by cancer. This helps the doctor decide if the tumor is early stage 1 which is treated with surgery alone.

Molecular Biology Testing

For lung cancer following molecular testing or gene mapping is done which guide us to plan further treatment in advanced disease.

  • Epidermal Growth Factor Receptor (EGFR) mutation.
  • Anaplastic Lymphoma Kinase (ALK).
  • ROS1 rearrangement.
  • T790M mutation.

 

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