Diagnosis

• Imaging is used to investigate cause of specific or non-specific cancer symptoms
• Can be targeted to look for a specific cancer, or a more generalised study

Staging

• Imaging is used to identify localised, locally advanced or metastatic disease
• Aids management decisions – curative vs palliative intent
• CT or MRI can be used to identify tumour relationship to adjacent structures – can determine surgical resectability

Metastatic disease

• CT usually requires IV contrast
• Skeletal metastases can be seen well on a bone scan
• MRI can assess for spinal cord compression - has high revolution for bone marrow
• Brain metastases on a head CT will be surrounded by a disproportionate amount of oedema
• The location of metastatic disease is dependent on the primary - will follow lymphatic drainage

TNM staging

• Globally recognised standard for classifying the extent of spread of cancer
• Most common tumors have their own TNM classification
• Example - bowel cancer:

T - primary tumour

• Tis: Tumour in situ, the tumour is contained within the lamina propria - it has not broken through the muscularis mucosae, thus the cells are still at their normal site