Inside the Chest: Navigating Challenges in Oncological Imaging

Moderator: Elsie Nguyen

Mistakes in Thoracic Oncology Imaging and How to Avoid Them
Daria Manos

Lung cancer is the most common cause of cancer death in Canada.  The increased per capita use of CT in Canada and improvements in CT technology have resulted in increased incidental detection and improved ability to detect early disease and early recurrence.  While this provides opportunities to enhance patient care, there are substantial challenges for the interpreting radiologist.   Using a case-based approach, this presentation will provide real-world examples of misses and interpretation errors in lung cancer imaging.  Focusing on CT, each case will illustrate a teaching point and be supported with available evidence.

By the end of this session, participants should be better able to:
- Recognize the types of lung nodules that are most likely to be missed or misinterpreted on CT.
- Determine when to consider malignancy as a cause of pleural thickening, consolidation, or endobronchial filling.
- Identify CT hot spots for early recurrence misses.

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SESSION EVALUATION

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Lung Cancer Screening – Lung-RADS 2022 Update
Carole Dennie

The Lung Screening Reporting and Data System (Lung-RADS) was created by the American College of Radiology in 2014 to standardize reporting and management recommendations for lung cancer screening.  One of the goals was to facilitate evaluation of quality and patient outcomes.  Since then, there have been two updates, the last in November 2022. Many provinces have adopted the ACR’s Lung-RADS in their lung screening programs as they are slowly deployed across Canada. This presentation aims to discuss the latest iteration’s new additions such as atypical pulmonary cysts and cavitary nodules, and explain the updates and clarifications regarding juxtapleural nodules, airway nodules and slowly growing nodules.  The stepped management of nodules and the re-classification of infectious or inflammatory findings are also reviewed.

By the end of this session, participants should be better able to:
- Recognize atypical pulmonary cysts, cavitary nodules and infectious or inflammatory findings on lung screening CT
- Define juxtapleural nodules and differentiate suspicious from benign airway filling defects 
- Illustrate stepped management of nodules

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SESSION EVALUATION

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Lung Cancer Staging: What the Clinician Wants to Know
Robert Lim

Review of lung cancer staging and the important thresholds clinicians require in radiology reports that impact management decisions.

By the end of this session, participants should be better able to:
- Recognize airway and chest anatomy and important lymph node levels for lung cancer staging
- Consider the impact radiology reports have on work up of lung cancer
- Identify important lung cancer characteristics that determine surgical resection or systemic therapy

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SESSION EVALUATION

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Diagnosis of Pulmonary Toxicity in Cancer Therapy A CT Pattern Approach
Carolina Souza

In this presentation, basic concepts of drug lung toxicity will be discussed with emphasis in new drugs currently used in cancer treatment. Using a case-based review format, the various patterns of drug reaction in the lungs will be reviewed using a CT pattern approach, along with clues for a prospective diagnosis.

By the end of this session, participants should be better able to:
- Discuss basic concepts of drug lung toxicity with emphasis on new drugs currently used in cancer treatment
- Review the various CT patterns of drug reaction in the lungs and provide clues for a presumptive diagnosis

Click below to complete the evaluation for this session
SESSION EVALUATION

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Q&A