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X-ray vs Ct scan

Nat107 profile image
53 Replies

Hi All, I just wanted to ask if anyone has had a clear normal X-ray result of their lungs then had different result from CT scan with contrast please thank you xx

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Nat107
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53 Replies
Carolineminiaturist profile image
Carolineminiaturist

Hi Nat. Yes I have and just had my Lobectomy . It could also be who looks at the X-ray. I was informed in A&E it was clear and then after my PET scan was told they had picked something on the xray. Hope all is good for you. X

Nat107 profile image
Nat107 in reply toCarolineminiaturist

Thank you very much, my X-ray was clear but I cough pinky brown sputtum up so dr had to send me for X-ray before referral for the Ct scan protocol apparently xx

Elt79 profile image
Elt79

I had X-ray earlier this year via GP for potential infection nothing of concern but oncology wanted CT with contrast as they said X-ray doesn’t show the same detail.

Nat107 profile image
Nat107 in reply toElt79

Thank you

Nat107 profile image
Nat107 in reply toElt79

Hope everything was ok for you x

Elt79 profile image
Elt79 in reply toNat107

It was thanks x

Kazzacrazy profile image
Kazzacrazy

Hi I was told my xray didn't show much but was sent for a ct scan where the tumour was discovered apparently not all lung cancers are picked up on a chest xray.

Nat107 profile image
Nat107 in reply toKazzacrazy

Thank You, I’m so glad the Ct found the tumour as nd do treated and not left in the result if the X-ray best wishes x

58trinity profile image
58trinity

Hello Nat107, a very good question, in my own experience i was given an all clear from a chest x-ray, my joy was short lived however, 8 weeks later i was given a Pet scan, which revealed that i had stage 4 liver cancer. (slow growing) so in my opinion x-rays were a waste of time. It was only thanks to a young trainee doctor that persisted with a Pet scan that my cancer came to light.

That was over 2 years ago now, and thanks to the radiotherapy and now immunotherapy, the tumour and other mets have slowed right down and i am feeling a lot better.

Hope everything goes well for you or the person you are enquiring for.

Nat107 profile image
Nat107 in reply to58trinity

Wow things could of been so different if not for the persistent doctor and a trainee too!, so glad you were checked properly though, we just don’t no what we are walking round with do we, glad your doing lots better now best wishes x

Ellejayb profile image
Ellejayb

Yes, I too had a different result on my CT scan. My tumour was (and I’m pleased to say ‘was’!) on the far right of my lung so was missed by an x-ray. I was told that lung tumours on females were more likely to be missed in x-rays because they tended to be peripheral whereas male tumours tended to be more central. I don’t know how accurate this is but recall being quite shocked to be told it!

The important thing is, you can get through this. My 8.5cm x 5.5cm tumour is now gone thanks to immunotherapy. Good luck!!

kri312 profile image
kri312 in reply toEllejayb

that is remarkable..can I ask if you had surgery and now immunotherapy? What stage was your tumor? Wish you continued clear scans!

Ellejayb profile image
Ellejayb in reply tokri312

It was stage 4 - too advanced for surgery. So I started off with chemo and immunotherapy and then went to immunotherapy alone. I wish you clear scans too!

kri312 profile image
kri312 in reply toEllejayb

thank you....set back was a blow for sure after almost 5 years! Need to get my head back in a good place again - honestly the hardest part!

Ellejayb profile image
Ellejayb in reply tokri312

Yes, the mind is the toughest bit!!

Nat107 profile image
Nat107 in reply toEllejayb

Really interesting to know this, and shows X-rays on there own really should t be used alone for investigating chest problems I’m so glad you are now ok and recovered best wishes x

JanetteR57 profile image
JanetteR57 in reply toNat107

there is a strict protocol for management of lung nodules and suspected lung cancer with escalation of tests and even if a chest x-ray appears normal but a GP still feels the patient has worrying symptoms, they can request a CT. In some areas there are trials for self-referral for CT by patients.

Millions had chest x-rays during the pandemic and since for all manner of symptoms - many of which overlap e.g. pneumonia, covid, lung cancer, infections etc and using different scans, along with blood tests and biopsies if required is the way cancer is diagnosed. Chest x-rays have a valid place in investigations as there are a myriad of lung conditions not just lung cancer and exposing people to repeated radiation for scans is a risk in itself.

Cancer cannot be detected from chest x-ray alone which is why so many tests are done - to rule in or out. If things are suspicious, more tests are needed as treatments vary considerably dependent on any biopsy results for mutations, protein levels etc for possible targeted agents or immunotherapy rather than standard chemotherapy, radiotherapy etc if a tumour is detected.

If early stage suspected, PET scans are often done to check if surgery can be possible or SABR - a form of radiotherapy otherwise known as ablation (cyber knife machine) which can be just as effective in those unable to tolerate surgery if it hasn't spread beyond the lung.

Nat107 profile image
Nat107 in reply toEllejayb

That’s really interesting fact regarding woman v men, do doctors even no this to delay so long for reoccurring symptom sone people. So glad though it is all gone god bless x

Ellejayb profile image
Ellejayb in reply toNat107

I’m not 100% sure if it is a fact - it’s something I was certainly told. Roy Castle can probably give the authoritative view. I have also been told - but again don’t know if it’s true - that female ‘anatomy’ close to the lungs can make it harder to get good imaging.

Nat107 profile image
Nat107 in reply toEllejayb

Really, interesting to no thank you

excavator profile image
excavator

Yes, my X-ray appeared clear but as I was coughing up blood was sent for a CT - subsequent PET scan showed cancer in right lung. Had pneumonectomy and chemo, clear for nearly 10 years now and eternally grateful for that.

kri312 profile image
kri312 in reply toexcavator

wow 10 years! Incredible. I have had 2 suguries on my right lung and know if comes back again will need it fully removed. I am still very active after 2 surguries (6 years ago for 1st and Oct 23 for most recent) - run, work out daily etc - with really only noticining SOB climbing hills. How is it with one lung missing completely?

Nat107 profile image
Nat107 in reply tokri312

Just to say my mum in law had only one lung since in her 20’s as she had tb and lived till a very grand age

kri312 profile image
kri312 in reply toNat107

Amazing....hoping not to have to go that route as 2 lung removals is enough as far as I am concerned :)!!! Let's hope the powers above agree.....

Nat107 profile image
Nat107 in reply tokri312

Hope so for you x

JanetteR57 profile image
JanetteR57 in reply toNat107

I learnt only relatively recently that I had an uncle who had his lung removed for TB in the 1950s and lived a full and long life. it's rare for lung cancer patients to have their whole lung removed - usually it's a lobe or two (the left lung has 2 and the right lung has 3) and for smaller, earlier tumours, some surgery can be less than a lobe (sub-lobar or wedge resections).

Nat107 profile image
Nat107 in reply toJanetteR57

Yes my mother in law had her lung removed in the 50’s also and lived a very long life.

My friend at the mine has been diagnosed with lung cancer and awaiting an operation herself, she too was only picked up in the over 55’s lung health check so shows how important this testing campaign has been, life saving for lots of people x

Nat107 profile image
Nat107 in reply toexcavator

Bloomin eck thank god doctor didn’t just rely on the X-ray as the result, I coughed up bright red blood in October for a day but nothing after it’s just chunks that are funny colours, so glad you are now clear, very worrying time to go through best wishes c

JanetteR57 profile image
JanetteR57

yes, it's possible but different imaging types are used for different purposes. Some organs show up better with different types of scan like MRI or ultrasound but for the lungs, chest x-ray is the usual first port of call then repeat CT or sent to CT for further investigation. Some shadows on chest x-rays turn out to inflammation which the CT can confirm/discount. CT scans are not all the same either. The type used in the targeted lung health checks on the mobile scanners in those areas of the country so far in the scheme use low dose CT scan whereas when somebody is symptomatic, it is usually a diagnostic CT that is used rather than a screening dose - sometimes with contrast and sometimes not.

My tumour (7cm - like an egg at the top of my left lung) showed clearly on chest x-ray but was ignored and a CT 5 weeks later showed it clearly so I was sent for a PET scan then had open surgery in Dec 2010 to remove it and half my left lung.

Some surgical patients are followed up with chest x-ray and others with CT scan. Those on the lung health checks screening programme are invited for a return low dose CT scan.

I recently had an inpatient CT scan without contrast but had difficulty lying still in the scanner due to coughing.

Images need to be read by thoracic imaging readers rather than more general radiographers - especially if anything is a little bit 'off' - chest x-rays are the most common investigative test carried out in hospitals even for those without chest symptoms - if you're admitted via A&E, in an accident or trauma, it's commonly one of the first tests to check out organs - but the vast majority of those having them are not found to have lung cancer.

There is a strong pathway protocol to investigate following one type of imaging with another or other tests like blood or biopsy if any suspicion remains.

I should say my first mammogram on a mobile scanner also resulted in me being invited to the hospital to have it redone as something didn't look quite right the year before my lung cancer diagnosis but the mammogram at the hospital didn't show anything suspicious. Imaging and tests are done as much to rule things out as in.

good luck with your scan and results.

Nat107 profile image
Nat107 in reply toJanetteR57

Thank you for all this information as it is very helpful in understanding, my hubby had the ct can check for over 55’s and found emphysema and invited for a repeat one few years later which was the same. Think on the 2ww X-ray has to be done before can have ct, my X-ray is clear so just waiting fur the act scan now. I always suffer from repeat lingering chest infections that take longer to leave with me, why did they ignore your X-ray when it clearly showed something that’s really awful and could of caused vital delay in treatment if not for you having the ct scan, dread to think, glad you are ok now and had the investigation needed eventually best wishes x

JanetteR57 profile image
JanetteR57

Glad your husband benefited from the lung health checks.

Re the order of images, my local hospital trust always does chest x-ray before CT but some Trusts have 'straight to CT' so it can vary.

I've had some nasty chest infections in recent years that take a while to shift. Those that have hospitalised me were all different (pneumonia, pseudomonas, RSV, unknown ).

Back in Oct 2010, I was discharged from A&E after almost 8 hours and the chest x-ray showing 'a lesion' on my left lung, with antibiotics and steroids in the wrong name too! readmitted next day by ambulance and kept in for a week, misdiagnosed and treated as uncontrolled asthma but didn't respond to medication.

I kept saying it wasn't like any asthma I'd had as not had asthma since early 40s (started age 6 - allergy driven) and recently had 52nd birthday at the time. They didn't listen nor look at the CXR. I was told I'd be sent for CT a week after discharge when symptoms had subsided so I could lie still and flat in the scanner.

The day before the appointment, had a call that the scanner had broken and they had to order parts. A delay of several weeks followed as the consultant was on holiday so they refused to change the scan to the other hospital site! Another week or so to get results from a registrar who broke the news totally unprofessionally then retracted when I asked questions saying she couldn't interpret the scan. Told my case would be discussed by the MDT in 2 days time, when another hospital phoned inviting me for a PET scan first thing the next morning. Then received an appointment with a surgeon. A few days after the PET results/MDT, his secretary phoned saying he had to see me at another hospital (tertiary surgical centre the other side of city) first thing the next day. He told me the large mass needed removing urgently and as they'd found it last month, they wanted to remove it with half left lung. He was shocked when I told him about the A&E and admission at another trust over a month before that - as he could only view results/actions from his own Trust's hospitals. 2 weeks later I had surgery at yet another hospital and it took another month to get the news it had been lung cancer. The whole period was surreal in many ways yet I kept on working, functioning and preparing for Xmas and showering/walking daily post surgery!

I've been involved in the cancer world for over a decade now and often think the A&E triage chest x-ray saved my life but was ignored/delayed. The emergency doctor told me she wouldn't have sent me for CXR when she discharged me on that first visit. The surgeon said a 7cm tumour takes a long time to develop so likely when I'd been to GP with chest infections for years - no imaging for decades so no clue when it started. The nurse who encouraged me to get involved took over a year to be diagnosed as her tumour was behind her heart so not visible on the chest x-ray but did show on CT. She was one of the first on targeted therapies in clinical trials back in 2011-15.

I'm thankful for every day yet crave increased awareness that anybody with lungs can develop problems irrespective of smoking status. I'd also like medics to consider even if somebody had a prior condition years ago, even if symptoms overlap, they need investigation rather than assumptions and delays. The pandemic should have taught us that . I'm inspired by others and when I became involved, encouraged by several long term survivors way before today's new treatments as had no idea people might return to everyday active lives. I appreciate not everyone has the outcome I've had and now work with those in the system to try and improve it for others. good luck.

Nat107 profile image
Nat107 in reply toJanetteR57

Omg your history is absolutely outrageous Janette, nhs failure 100% from more than one dept, the feeling of if only and if they didn’t comes to mind from these results, I’d be very angry if I was you as that is just so bad. So glad though someone was watching over you to finally get things moving the way the should of been from the beginning,

I totally agree with presumptions going by years old medical history and conditions at present as everyone is blamed on my ibs for stomach & bowel until I had a massive haemorrhage which ended up in A&E who were no help at all last April, this is is still ongoing after scopes and blood tests as aenemic for a while, so blood has to have came from somewhere if not from my bowel. The chunks I cough up up are random when need to clear my chest & throat but X-ray was clear hence my Ct, not sure if the blood is coming from my lungs or throat area to be honest.

I am so glad you are now ok and albeit too long in diagnosis you are doing ok now, it’s not good being failed by the people we trust in, that’s why I do believe our health is in our own hands at first instance. Great that you are working to help others that’s so good if you god bless xx

JanetteR57 profile image
JanetteR57

having lost my younger sister at 40 in 2001 (fell between different services in mental health and health) and my older sister in late 2022 from undiagnosed heart condition despite complaining of symptoms presumed to be 2 existing conditions by community services who clearly didn't talk to one another or compare notes (as classic heart condition symptoms) but lack of physical appointments from GP as fallout from pandemic saw for her, unexpected death of my niece (33) in 2019 from catastrophic bleed on her brain mean I tend to look differently on life and think it could have been worse for me.

Sorry to hear about your ongoing issues. When I've coughed up blood with bad chest infections, the hospital and GP have said likely burst blood vessels after strenuous violent coughing as scans/images of various structures haven't shown recurrence even with a lung cancer history. Fingers crossed, yours has a similar explanation or at least they can track it down and treat whatever is causing it.

We lost a family member to pancreatic cancer at the end of last year 15 months after diagnosis after her GP told her and treated for diabetes a year earlier.

Many have similar stories so it can feel a postcode lottery despite national clinical guidelines, training standards, accreditation etc but if staff aren't there or those who are lack experience, or dependent on agency staff, with the increased demand, the whole system is collapsing in different places - not helped by the lack of negotiation over industrial action.

I just wish the different clinics and services were joined up by a common IT system so records could be read by medics anywhere. It would prevent such waste including time, resources and life.

However given the fallout from the Horizon post office system, despite being decades overdue,I can't imagine any political party agreeing to a new NHS IT system anytime soon nor any private sector company bidding for such a system.

Nat107 profile image
Nat107 in reply toJanetteR57

Oh I’m so sorry to hear about your family, you have lost so many and must of had a most awful time of it, if only communication and working together starting by simply just taking time to read patients history & notes, it would be a big start to joining the dots together to authorise the best diagnostic tests and plans going forward, I think instead of having to explain symptoms over n over again to each different doctor or hospital assistant you pass through in reading patients notes which is literally in front of them on the computer along with all medication taken but still they ask what medication are you on, the information is all right there in front of them yet they can’t read through the history far back enough. Communication is definitely the key between trusts and gp & hospitals and only just some hospitals are merging to share notes between themselves but not all as yet which would be a big improvement x

Cmtd profile image
Cmtd

Xray total waste of time for cancer. I had a lung xray came back clear .....6 wks later ct scan came back lung cancer tumour.The hospital said the tumour was behind a main artery so was missed on the xray.i found this a weak excuse!

Nat107 profile image
Nat107 in reply toCmtd

Omg absolutely awful and left feeling a false sense of everything is ok feeling if X-ray is clear, definitely right to feel angry about this hope you are doing ok now and getting the treatment you need x

RoyCastleHelpline profile image
RoyCastleHelplinePartnerAsk the NurseRoy Castle

Hi Nat107,

Sorry to hear of your health worries. This must be a worrying time. I see you have had excellent responses from others on this forum with regards to the question of results from Chest X-ray versus CT Scan. A CT Scan shows much more detailed images than an x-ray and therefore is often included as part of investigations. While a normal chest x-ray is reassuring, it does not explain symptoms so as others have suggested, for a definitive diagnosis (of many conditions) this requires a bigger picture than just one investigation and will include medical history, signs and symptoms, clinical exam, routine then robust investigations. Cancer characteristics do differ according to many variables including gender, race, age and DNA. and investigations need to be individually tailored and meet pathway protocols.

You can find out more about investigations here roycastle.org/about-lung-ca...

All our information leaflets are available here roycastle.org/help-and-supp...

Good Luck with your CT Scan

All the best

Roy Castle Support Team

Nat107 profile image
Nat107 in reply toRoyCastleHelpline

Thank you very much, I shall take a look through your link very much appreciated

I have indeed received very helpful responses from the group which helps so much when things aren’t adding up so the group is a great help thank you

Kasuku profile image
Kasuku

Hallo Nat107.I was diagnosed with non small cell cancer of lungs in May 2022.

My Chest X-ray was normal, lung function tests normal, but the CT scan showed an abnormality in my right lower lobe. And my journey started from there.

Nat107 profile image
Nat107 in reply toKasuku

Oh my, feeling good when you first get good results leads into a false sense of happiness doesn't it, how are you now, I hope you are doing ok. What were your symptoms to lead to testing please x

Kasuku profile image
Kasuku in reply toNat107

This was before Covid 19.I used to get irritable coughs, sneezing from any dusty environment. My GP and I thought of allergies and gave me inhalers which never worked. So my GP ordered Chest x-ray, which was normal, but my symptoms persisted and I was referred to llandogh respiratory team. Who took over.

I am doing very well so far on Targeted Therapy, on Osimertinib (Teggreso) tablet once a day, 18 months on.

I am seen by the oncologist every 8 weeks now. I get chest and abdomen scans every 3 months to monitor my progress. The last two scans showed no progression of the cancer.

I remain positive, taking a day at a time, continuing with my routines making the best of every situation. I pray and trust God is in control.

Nat107 profile image
Nat107 in reply toKasuku

I’m glad you are getting closely monitored and seen by oncologist, I do believe having faith and being positive has such a big affect when going through anything like this, my family member had non Hodgkin’s lymphoma which returned back 3 times and was always so positive even when the first & second time it was 50/50, keep positive and hid will always be with you too god bless xx

Kasuku profile image
Kasuku in reply toNat107

All the best for you, stay positive.

Nat107 profile image
Nat107 in reply toKasuku

Thank you all the best to you too x

Greshams29 profile image
Greshams29

Hi

My dad had top left part of lung removed just over 4 years ago fir Lung Cancer

He was scanned every year. The last scan they said they were watching something but to go away and don’t worry.

Jump to a year later and the next scan, saw something so had ct scan, then pet scan. Turns out cancers back in the remaining left lobe and it’s 7cm , too big for surgery they said.

Dad had 4 cycles of chemo and now only 3 weekly immunotherapy. He caught a bad infection a few weeks ago and ended up in hospital for 5 days. Been gone a couple of weeks but had to go back to the doctor and given more antibiotics.

He’s still in pain near his left lung are and has a cough , took him up to oncology department , but they said you have cancer so are going to be in pain.

Did an X-ray but said all looks fine and sent him home with morphine and codeine linctuse for the cough.

He doesn’t seem well this time so hoping he gets an earlier ct scan just to put his mind at rest and ours.

He’s stage 4 lung cancer and they said not cure able

Just hard at times.

Too top it off we just buried my husbands dad on Dec 19th. He was diagnosed with lung cancer and died 3 weeks later.

I’m hoping selfishly that my dad goes on for years, but I know he’s in pain and not sure he would have more chemo .

Nat107 profile image
Nat107 in reply toGreshams29

Oh I’m so sorry to hear about your dad, he’s really been through a lot and ultimately family goes through it also. It’s such a worrying time. My sister had cancer 3 times and each time we didn’t think she would come through it again but she did, 1st & 2nd time didnt look good either, that was non hodgkins lymphoma. Her poor veins collapsed having that much treatment.

So sad you also lost your husbands dad, on top of you dad being so ill too.

Which was it that they said they seen something but not to worry before your dad had the CT scan followed by pet scan. Was it normal X-ray,

Surely having had lung cancer before and then them seeing something more investigations should have followed straight away if not sure what it was, time is so important isn’t it. It’s really hard having to watch our parents in pain and I hope he gets some relief somehow, could your gp not help further for him I do hope so hod bless xx

Greshams29 profile image
Greshams29 in reply toNat107

Hi Nat

It was last year when they did the ct scan, they were watching something.

His cray last week looked ok and the oncologist compared it to the last cray and said nothing has changed.

He had a bad coughing fit for over half an hour the other night. He rang oncology the next day and they said carry on with the morphine and cough medicine for another few days.

Guts we will just have to wait until Feb 15th for his ct scan.

Nat107 profile image
Nat107 in reply toGreshams29

So sorry it must be such a worrying time for you, hope this next 2 weeks goes quickly so he can get his ct scan

Greshams29 profile image
Greshams29 in reply toNat107

Hi Nat

My dad died on 14 July

They said he was too weak for more chemo and gave him a week or two to live.

He dies 6 days later.

Still struggling to understand it all x

Nat107 profile image
Nat107 in reply toGreshams29

Oh my I’m so very sorry to hear your very sad news, sounds like you poor Dad went through such a lot, and it’s no sounds like consolation at all all but he is now finally out of his pain and discomfort, and it’s also hard for you to see him suffering. It’s Such a horrible disease that touches so many people, my auntie had lung cancer also and passed easy at 63 and my mum had breast cancer at 42 and had a mastectomy & womb cancer hysterectomy but she’s now nearly 80 but has other debilitating medical conditions and it’s so hard to watch our parents go down hill & suffer. hope you are doing ok lovely, take care xx

Nat107 profile image
Nat107

UPDATE:- Ct results = everything fine apart from a 3mm solid nodule on the left lung lobe so they just made a note of that but no follow up

xinte60 profile image
xinte60

Yes, had 2/3 of lung removed beginning of January for lung cancer, few weeks ago was admiited to A&E for coughing and breathlessness, was given an x ray, all clear, one of the Doctors wanted CAT scan with contrast as my inflammatory markers were so high, turned out I had pneumonia and Pulmonary embolisms in both lungs, So I'm very glad that Doctor insisted on the CAT scan

Nat107 profile image
Nat107 in reply toxinte60

Thank you for the reply, Wow you had a good doctor looking after you for sure, so glad you were taken care of with follow up testing

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