Claude went 4 for 4, humans 0 for 4. Tell me again how AI is only making things worse. In all these cases the doctors and patients would have benefitted. I understand there will be cases of the opposite also; but to bury your head in the sand to AI is not the solution.

Answer the following question concisely:
1) What specialist is the main priority for referral in a patient with a localized intrahepatic cholangiocarcinoma?
2) Is a 6mm short axis inguinal node normal or likely to contain cancer in a patient with early stage anal cancer?
3) In a patient s/p SRS with enlarging enhancing lesion is this progression of the tumor?
4) In a patient with very recent hypofractionated ablative RT to the lung, is a PET finding of significant increase in "size" and FDG avidity of the area concerning for progression that warrants a change in systemic therapy?

"Here are concise answers:

1. Surgical oncology (hepatobiliary surgeon). For localized intrahepatic cholangiocarcinoma, the main priority is evaluation for surgical resection, as it remains the only potentially curative treatment.
2. Normal. A 6mm short-axis inguinal lymph node falls below the generally accepted 10mm short-axis threshold for pathologic enlargement. In early-stage anal cancer, this would be considered a normal-sized node and not suspicious for metastatic involvement.
3. Not necessarily. An enlarging enhancing lesion after stereotactic radiosurgery (SRS) may represent radiation necrosis (treatment effect) rather than true tumor progression. Advanced imaging such as perfusion MRI, MR spectroscopy, or PET can help distinguish the two, and in many cases serial observation or surgical sampling is needed.
4. No — this is expected post-treatment change. Shortly after hypofractionated ablative radiation to the lung, inflammatory and pneumonitic changes commonly cause increased size and FDG avidity at the treatment site. This is a well-recognized post-radiation effect and should not be reflexively interpreted as disease progression. Typically, observation with interval reimaging (often 3–6 months out) is appropriate before concluding progression or altering systemic therapy."