Stories about: CT scans

Less is more: Do Hodgkin’s survivors really need CT scans after treatment?

shutterstock_101761009It’s music to the ear of any cancer patient: “Your scans are clear.” It means you’ve won, and the treatments you’ve endured have driven cancer from your body.

But once you hear those four magic words, are you also free of the need for future scans? There’s an argument to be made that continued scanning or surveillance imaging is a good thing. After all, if you have a relapse, you want to detect it as early as possible.

But that argument may not hold up in the face of data. Continued imaging can be expensive, can expose survivors to additional radiation, can have false positive results leading to additional worry and unnecessary medical care, and may not be any better at detecting tumor relapses than a physical exam or simply a survivor’s feeling that something is “wrong.”

Stephan Voss, MD, PhD, the director of Nuclear Medicine and Molecular Imaging and chief of Oncologic Imaging at Boston Children’s Hospital, decided to crunch the numbers, using Hodgkin lymphoma (HL) as a model for testing whether post-treatment surveillance with computed tomography (CT) scans makes clinical sense. His conclusion: not really.

“The conventional wisdom is that early detection of relapse means that we spare the patient side effects and poorer outcomes,” Voss says, referring to the belief that HL survivors should have a follow-up CT scan every year for up to five years after treatment. “But with Hodgkin disease, that’s not the case.”

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