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While complete staging relies on a combination of clinical findings, including blood tests, radiology provides the cen-tral and pivotal staging process, so the radiologist’s role at this point in the cancer care continuum is absolutely essential. As well as managing and operating the equipment used for staging and diagnosis, and selecting the methods used to carry out the examinations, the radiologist is also the person who will analyse and interpret the resulting images, with reference to important clinical knowl-about the patient’s current condition and medical history. The radiologist is therefore relied upon not only to detect already evident findings, but to know to where a given tumour may spread and to confirm or exclude the presence of local and distant metastases (the new sites of spread) through detailed analysis of these locations. “The radiologist has a fundamental understanding of the strengths and weaknesses of the imaging tools available and which imaging modalities are best suited for the investigation of particular tumour types. Particular cancers are best appreciated with certain types of investigations and a radiologist is best situated to know which is the most appropriate investigation to use.” The radiologist’s expert analysis will be an integral factor in the decision about the course of action to be taken, but the decisions are usually made by a multidisciplinary team of doctors, responsible for the management of each cancer patient. Images obtained in the examinations will be presented and commented on by the radiologist, before being discussed by the team, usually including oncologists and pathologists. Frequently, new questions may be raised, due to new events or bio-logical findings, and very commonly, the radiologist will return to previous examinations with the same or another imaging tool, in order to characterise images or to ensure that nothing was missed.
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