Lung tumor CT scan with or without contrast?

Either. I usually do them without so I don't expose the patient to the contrast, which can injure kidneys. However, if the tumor is close to the mediastinum, I usually do order it with contrast because it's often difficult to tell the various structures apart without it. It also helps to identify lymph nodes.

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Why would a ct scan not detect a lung tumor and why are they better than a X-ray?

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