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Occult brain metastases can cause under staging with 18 F- FDG PET-CT imaging.
Moreover, in most of the ontologies cognitive tests are not classified under staging, but rather as cognitive tests.
Gleason score obtained by biopsy was allowed in our series, and this may reflect an under staging in some patients.
CT provides good anatomic definition but with significant over and under staging with a reported accuracy of 62 88% (Fig. 2).
The possibility of over staging and under staging of tumors can occur due to discrepancy resulting from additional echoes produced by the interfaces between the different histologic layers.
As has been shown in pathology audits, the absence of explicitly stated prognostic factors in reports can result in false-negative assumptions and can potentially lead to under staging and under treatment of patients.
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Because radiologists will tend to over-stage rather than under-stage, relatively high over-staging rates (up to 50%) as compared with primary staging have been reported.
Including erosions only in the assessment of bone destruction in children may therefore lead to both over- and under-staging of disease.
Recent studies have shown that definitions extrapolated from research in the adult population cannot automatically be used in children and may lead to both over- and under-staging of disease [21, 29, 30, 31].
The difference is particularly marked in the under-staging of DCIS.
Specimens containing <3 CLNs retrieved during pCND (n = 38) were excluded to reduce the possibility of nodal under-staging.
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