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SEER Training Modules

X-rays

Key information

Information to look for and pay attention to and to document with regard to collecting pertinent information about the patient's cancer

Size and location of primary tumor; relationship of mass to other tissues, such as impingement or extension to another tissue (ribs, chest wall, pleura); elevation of diaphragm on one side (phrenic nerve paralysis); hilar or mediastinal involvement; enlargement or decrease in size of lung(s); opacity, such as atelectasis, pleural effusion or pneumonitis; masses in mediastinum and/or hilum of lung; involvement of distant sites.

Angiography (Celiac and TranshepaticRANSHEPATIC)

Also called:

Percutaneous transhepatic cholangiography (PTC). Evaluation of the liver and biliary tree using contrast material injected through the skin directly into the liver. Key words/possible involvement: hypervascularity, stricture, extrinsic mass, lesion, neoplasm, malignancy, opacification, nonvisualization.

Barium Enema

Also called:

BE, double contrast barium enema, air contrast barium enema, air contrast study, barium contrast study of the colon.

Key words/possible involvement:

Lesion, irregular density, stricture, shouldered stricture, applecore lesion, filling defect, obstruction, stenosis, polyps, villous adenoma, fistula.

Other words/no involvement:

No visible abnormality in the colon, diverticulosis, megacolon, ulcerative colitis, Crohn's disease, abscess, or infectious process, or other benign conditions.

Words indicating unsatisfactory procedure:

Not satisfactory due to residual fecal material in the colon or incomplete preparation of the colon.

Bronchogram

Also called:

Bronchography; examination of the bronchial tree using contrast media.

Key words/possible involvement:

Lesion, irregular density, stricture, narrowing, blockage, shouldered stricture, applecore lesion, filling defect, protrusion, obstruction, fistula, extravasation, abnormal contour, bleeding.

Other words/no involvement:

No visible abnormality in the bronchi; inflammation, bronchitis, congenital abnormalities, spasm, edema, abscess, infectious process, or other benign conditions.

Cerebral Angiography

Invasive radiographic procedure that injects dye into cerebral vessels to determine the location of and blood flow to a brain tumor. The contrast material visualizes the blood vessels and helps determine the planes of resection. Also called: brain angiograms.

Key words/possible involvement:

Stricture, mass, mass effect, extrinsic mass, metastases, filling defect, obstruction, space occupying lesion, neovascularization, vascular parisitization.

Other words/no involvement:

If there is no specific reference to abnormality of the cerebral vasculature; references to cysts, hamartomas, angiomyolipomas.

Chest X-Ray

Also called:

CXR, AP and PA chest films, chest radiographs, chest roentgenograms.

Key words/possible involvement:

Lesion, irregular density, coin lesion, cannonball lesion, nodular lesion, cavitary lesion, homogenous parenchymal lesion with sharply defined margins, multiple opacities, multiple pulmonary nodules, unilateral hilar enlargement, pleural effusion, pleural masses, rib lesion with adjacent soft tissue mass, mediastinal mass, metastases.

Other words/no involvement:

Calcifications, hamartomas, granulomas, bronchogenic cysts, vascular abnormalities, and other benign conditions

Cholangiogram

Also called:

Percutaneous cholangiogram, skinny needle cholangiogram, intravenous cholangiography, T-tube cholangiogram (postoperative procedure). Sequential x-rays which evaluate the liver, gallbladder and bile ducts using contrast material injected intravenously.

Key words/possible involvement:

Hypervascularity, stricture, extrinsic mass, lesion, neoplasm, malignancy, opacification, nonvisualization.

Other words/no involvement:

If there is no specific reference to visible abnormality in the organ; inflammatory process, foreign bodies, or other benign conditions.

Cine-Pharyngoesophagram

Also called:

Cineradiography. Serial (moving picture) x-rays of the aerodigestive tract. Allows dynamic (with motion) visualization of swallowing function, as well as strictures and other abnormalities.

Cystogram

X-rays to visualize the bladder after the introduction of radiopaque contrast via urethral catheter. After the patient voids, air may be used as a second contrast agent. Also called cystography, double contrast cystogram.

Key words/possible involvement:

Stricture, mass, mass effect, metastases, surface irregularities of bladder, filling defect in the bladder, non-functioning kidney, ureteral obstruction.

Other words/no involvement: if there is no specific reference to abnormality in the bladder.

EEG (Electroencephalogram)

Measurement of electrical impulses from the brain by placing electrodes on the outside of the head to record brain activity. The usefulness of EEG has diminished in recent years because CT scanning yields more detail.

Key words/possible involvement:

Abnormal pattern, abnormal reading, abnormality.

Other words/no involvement:

If there is no specific reference to abnormality in the brain, including references to abscesses, subdural hematomas, hematomas, cerebrovascular disease, cerebrovascular accident, infarction, trauma.

Esophagram

Also called:

Esophagogram, barium swallow, cineradiography. Includes fluoroscopy of esophagus.

Key words/possible involvement:

Lesion, irregular density, stricture, shouldered stricture, applecore lesion, filling defect, obstruction, fistula, extravasation, abnormal contour, bleeding.

Other words/no involvement:

No visible abnormality in the esophagus; normal peristalsis, diverticuli, inflammation, esophagitis, esophageal varices, congenital abnormalities, spasm, edema, abscess, infectious process, or other benign conditions.

IVP (Intravenous Pyelogram)

A series of x-rays which evaluate the structure and function of the kidney, ureters and bladder after radiopaque dye has been injected intravenously. Also called: excretory urogram, pyelography. Excludes: KUB (Kidney-Ureters-Bladder) radiography during which no dye is injected.

Key words/possible involvement:

Stricture, mass, mass effect, stricture, nonfunctioning kidney, metastases, surface irregularities of bladder, filling defect in the bladder, ureteral obstruction.

Other words/no involvement:

If there is no specific reference to metastases, lesion, or visible abnormality of the kidneys, ureters, or bladder.

KUB (Kidneys-Ureters-Bladder)

X-rays to evaluate the status of the urinary system. No dye is injected during the procedure.

Key words/possible involvement:

Stricture, mass, mass effect, metastases, surface irregularities of bladder, filling defect in the bladder, nonfunctioning kidney, nonvisualized kidney, ureteral obstruction.

Other words/no involvement:

If there is no specific reference to visible abnormality in the urinary tract.

Lymphangiogram

Radiographic examination of the lymphatic system of the trunk by injecting dye into a lymphatic vessel in each foot to determine retroperitoneal involvement. The following areas should be visualized to adequately assess extent of disease: lymphatics of the legs, inguinal and iliac regions, and retroperitoneum including periarotic. Does not visualize the mesenteric, celiac or portal nodes. Also called: pedal/bipedal lymphangiography, lymphography, LAG. (With the advent of CT and MRI scanning, this invasive procedure is less frequently done.)

Key words/possible involvement:

Area of increased density, area of enhanced contrast, space occupying lesion, diffuse nodularity, decreased uptake, decreased activity, lymphadenopathy, filling defect, lack of opacification, enlarged or foamy-looking nodes.

Other words/no involvement:

No specific reference to visible abnormality in the lymph nodes of the trunk.

Mammogram

Unilateral (involved breast), bilateral (both breasts), contralateral (side not suspected of containing cancer).

Key words/possible involvement:

Lesion, mass, irregular density, clustered calcification, spiculation, mammary duct distortion or asymmetry, nodular density, skin or nipple thickening, enlarged lymph nodes.

Key words/no involvement:

If there is no specific reference to visible abnormality in the breast under suspicion.

Metastatic Work-Up

Any imaging or other test to assess the presence of other organ primaries which may have caused a metastatic brain tumor; any imaging or other testing to look in organs distant from the primary site for evidence of metastases.

Nephrotomography

Radiographic evaluation of kidneys by taking films of serial, thin sections of renal tissue. Also called: renal tomography, renal tomos. Excludes: computerized tomography of the lungs and plain x-rays of the kidneys.

Key words/possible involvement:

Lesion, irregular density, space occupying lesion, cavitary lesion, homogenous parenchymal lesion with sharply defined margins, multiple opacities, metastases.

Other words/no involvement:

If there is no specific reference to visible abnormality in the lungs; references to calcifications, hamartomas, angiomyolipoma, granulomas, cysts, vascular abnormalities, and other benign conditions.

Pneumoencephalogram

Injection of air contrast into the cranial cavity to evaluate the midline brain (pituitary and cranial fossa) structures and the brain stem. This is a very dangerous procedure and should not be used except in cases where a diagnosis cannot be reached any other way. The usefulness of pneumoencephalography has diminished in recent years because CT scanning yields more detail.

Renal Angiography

Invasive radiographic procedure that injects dye into renal vessels to determine the location of and blood flow to a kidney tumor. The contrast material visualizes both the renal blood vessels and the collecting systems. Also called: digital intravenous angiography, digital fluorography, renal arteriography, renal venography, renal angiogram.

Key words/possible involvement:

Stricture, mass, mass effect, extrinsic mass, metastases, filling defect, obstruction, space occupying lesion, neovascularization, vascular parisitization.

Other words/no involvement:

If there is no specific reference to abnormality of the renal vasculature; references to cysts, hamartomas, angiomyolipomas.

Renocystogram

X-rays to visualize the bladder, ureters and kidneys after the introduction of intravenous radiopaque contrast material.

Key words/possible involvement:

Stricture, mass, mass effect, metastases, filling defect in the kidney or bladder, nonfunctioning kidney, ureteral obstruction.

Other words/no involvement:

If there is no specific reference to abnormality in the urinary tract.

Retrograde Pyelogram

Series of x-rays to evaluate the upper urinary tract by using a cystoscope to insert catheters through ureters to level of renal pelvis and inject radiopaque contrast dye. The pelvis, calyces and ureter of a kidney are visualized during this procedure. Retrograde pyelogram is useful if intravenous pyelography is inadequate due to nonvisualized kidney. Also called retrograde pyelography.

Key words/possible involvement:

Mass, stricture, lesion, filling defect, extrinsic mass, narrowing, metastases, nonfunctioning kidney.

Other words/no involvement:

If there is no specific reference to visible abnormality in the urinary tract.

Sialography

Radiographic examination of the salivary ducts; not recommended as a diagnostic tool because of the possibility of introducing sepsis.

Skull Radiographs

X-rays of the bones of the skull to determine the presence of tumor and its effect on internal structures in the brain. Also called skull films.

Key words/possible involvement:

Midline shift, calcification, skull or sella turcica erosion, erosion of inner table, stricture, mass, mass effect, metastases, filling defect, obstruction (to cerebrospinal fluid flow), space occupying lesion.

Other words/no involvement:

If there is no specific reference to abnormality of the cerebral vasculature; references to cysts, hamartomas.

Small Bowel Series

Also called:

Enteroclysis. Includes fluoroscopy of the small bowel. Excludes: upper gastrointestinal series (UGI).

Key words/possible involvement: lesion, irregular density, stricture, shouldered stricture, applecore lesion, filling defect, obstruction, polyps, villous adenoma, bleeding, deformity of duodenum.

Other words/no involvement:

No visible abnormality in the small bowel; congenital atresia, regional enteritis, ulcerative colitis, Whipple's disease, sprue, lymphoid hyperplasia, malabsorption syndrome, intussusception, edema, abscess, or infectious process, or other benign conditions.

Words indicating unsatisfactory procedure:

Not satisfactory due to residual material in the small bowel or incomplete preparation of the small bowel.

Stomach X-Rays

Also called:

Gastric radiography.

Key words/possible involvement:

Lesion, irregular density, stricture, shouldered stricture, filling defect, obstruction, fistula, extravasation, perforation, thickening of wall, abnormal contour, extrinsic mass, bleeding, ulcer (unless described as benign or non-malignant), enlarge rugal folds, deformity of pylorus.

Other words/no involvement:

No visible abnormality; normal peristalsis, diverticuli, inflammation, varices, pyloric stenosis, gastritis, congenital abnormalities, foreign bodies, spasm, edema, abscess, infectious process, or other benign conditions.

Words indicating unsatisfactory procedure:

Not satisfactory due to residual food or fluid in stomach.

Tomograms

Also called:

Tomos or tomography, body section radiography, planigraphy, laminography, stratigraphy. Evaluation of a plane or level of tissue (most commonly the larynx or paranasal sinuses) which can reveal tumor size, location, and extension into other structures. See also Whole Lung Tomograms.

Key words/possible involvement:

Mass, bony tumor involvement, obstruction, abnormal contour.

Other words/no involvement:

No visible abnormality; or reference to foreign body, inflammation, congenital abnormalities, edema, abscess, infectious process, or other benign conditions.

Upper GI Series

Also called:

UGI, double contrast Upper GI series. Examination of the esophagus, stomach and small bowel in one procedure.

Key words/possible involvement:

Lesion, irregular density, stricture, shouldered stricture, filling defect, obstruction, fistula, extravasation, perforation, thickening of wall, abnormal contour, extrinsic mass.

Other words/no involvement:

No visible abnormality; normal peristalsis, diverticuli, inflammation, congenital abnormalities, foreign bodies, spasm, edema, abscess, infectious process, or other benign conditions.

Words indicating unsatisfactory procedure:

Not satisfactory due to residual food or fluid in upper gastrointestinal tract.

Whole Lung Tomogram

Radiographic evaluation of lungs by taking films of serial, thin sections of lung tissue. Also called: whole lung tomography, chest tomos. Excludes: computerized tomography of the lungs and plain x-rays of the lungs. See also Tomograms.

Key words/possible involvement:

Lesion, irregular density, coin lesion, cannonball lesion, nodular lesion, cavitary lesion, homogenous parenchymal lesion with sharply defined margins, multiple opacities, multiple pulmonary nodules, unilateral hilar enlargement, pleural effusion, pleural masses, rib lesion with adjacent soft tissue mass, mediastinal mass, metastases.