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Thread: MRI Or CT

  1. #1
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    MRI Or CT

    Hello
    What is the different between MRI to Bone Scan
    To check for metastasis from Prostate Cancer?
    What is better?

  2. #2
    Senior User DjinTonic's Avatar
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    The MRI is good for imaging soft tissue--the prostate itself and metastases to other body organs. When it metastasizes, however, prostate cancer has a particular affinity for bone, which is very dense. The bone scan, done with radioactive (but safe) dye, is designed specifically for that. Since they look primarily at different things, one isn't "better" than the other. When there is a concern that high-grade cancer has possibly spread by metastasis, the doc usually wants to check both, bones and body organs. Having this information can, of course, influence treatment decisions. Before surgery, the MRI can also tell the doc if anything untoward (besides prostate cancer) is going on.
    Last edited by DjinTonic; 10-12-2017 at 03:58 PM.
    69 yr at Dx, 20-yr Hx of BPH, 9 (!) negative biopsies, PCA3 -
    TURP 2014 (90→30 g) then PSA every 6 months, DRE yearly
    DRE 6-6-17 nodule R, PSA 7.2→8.6
    Biopsy #10 6-28-17, 2/14 cores: G10 (5+5) 3% RB, G9 (4+5) 50% RLM
    Bone scan & CAP CTs: negative
    Open RP 8-7-17 at Duke Regional (NC) by my Uro, did my '14 TURP, 8-20 RPs/month >20 yr
    SM/LVI/SVI/EPE/LNI (16): negative, PNI +, nerves spared
    pT2c pN0, b/l adenocarcinoma G9 (4+5) 5% of prostate (4.5x5x4 cm, 64 g)
    Cath 2 weeks, very slight stress dribble at 11 weeks, improving
    PSA 9-16-17 (5 weeks) <0.1
    ED (BPH) still OK with sildenafil
    Awaiting Decipher result, taking Pomi-T
    Next visit discuss: checkup schedule, Decipher, BCR, SRT, uPSA

  3. #3
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    Thank you very much for your reply

    Also I would like to ask what is the different between NRI
    To CT to diagnose metastasis from Prostate Cancer?

    Quote Originally Posted by DjinTonic View Post
    The MRI is good for imaging soft tissue--the prostate itself and metastases to other body organs. When it metastasizes, however, prostate cancer has a particular affinity for bone, which is very dense. The bone scan, done with radioactive (but safe) dye, is designed specifically for that. Since they look primarily at different things, one isn't "better" than the other. When there is a concern that high-grade cancer has possibly spread by metastasis, the doc usually wants to check both, bones and body organs. Having this information can, of course, influence treatment decisions. Before surgery, the MRI can also tell the doc if anything untoward (besides prostate cancer) is going on.

  4. #4
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    I see a lot of folks getting 3T MRI. Is that similar are the same as mpMRI with endorectal coil? Which is better?
    --------------------------------------------
    Born 1981
    1.6 PSA on 7/1/16
    1.91 PSA. .59 PSA Free 27.7% PSA Free % on 12/19/16
    1.98 PSA on 3/9/17
    4.9 PSA on 9/11/17
    TRUS Biopsy on 10/4/17. Negative for malignancy in all 12 cores.
    3T mpMRI on 12/20/17

  5. #5
    The Tesla ratings of 1.5 and 3 refer to the power of the machine. "mp" means that the machine's software is set up to record three assays, which greatly increases the value for analyzing prostate cancer. The PIRADS score is generated by those three assays.

    An endorectal coil or an apron coil can be used with either 1.5 or 3 machines. The ERC was recommended with 1.5, but not required on the 3T.

    Trust me, you do not want the ERC, as it is extremely uncomfortable. Think of being reamed with a police baton. The apron coil is no problem.

    Both machines use a contrast dye, which is intravenously injected.
    DOB: May 1944
    In Active Surveillance program at Johns Hopkins
    Five biopsies from 2009 to 2014. The third and fourth biopsies were positive with one core and three cores <5% and G 3+3. Fifth biopsy was negative.
    OncotypeDX: 86 percent chance of PCa remaining indolent
    August 2015: tests are stable; no MRI or biopsy this year for my AS program
    August 2016: MRI unchanged from 2/2014; PSA=3.9; FPSA=26; PHI=28. No biopsy necessary.

    A NOTE ON PSA: My readings have been erratic for over 10 years; typically being 3.5-4.2, but spiking to over 10 at times.
    These spikes are asymtomatic to me, and resolve themselves. A prostate biopsy can triple the PSA, which lasts for months.
    Last Free PSA was 26. I don't worry about PSA spikes anymore.

  6. #6
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    Sma,

    Just met with my RALP Uro, last week and he thinks my cancer has left the Prostate, although the biopsies don't seem to indicate that (also no PNI). So, he wants an MRI (of the Prostate) before he operates, to help plan his strategy. So, I get a DPHC MRI 3T next Monday. The appointment allows for 80 minutes.

    I had NUC bone scans and CT of the pelvis and abdomen and they were both negative. So, those were not enough for him to clearly see the Prostate, apparently?

    Hope this helps?
    69 yr. old DOB 4/7/48 Troy MO-just W of St. Louis
    PSA 3.2 7/08 Slightly enlarged
    No PSA DONE w/labs. 2013 due to 0 symptoms-MISTAKE
    PSA 51.2 (7/11/17), 0 symptoms
    DRE hard on left, 31g size (norm 25g) 7/24
    Biopsy 8/11 No PNI
    /////**********|**********BASE**********|********\
    ////***88%****|***66%*****|****6%*****|**PIN****\
    ///*GS 4+4 = 8*|*GS 4+3 = 7*|*GS 4+4 = 8*|**********\
    //************|************|************|**********\
    |*****87%****|***70%*****|****9%*****|***4%*****|
    |**GS 4+4 = 8*|*GS 4+4 = 8*|*GS 3+4 = 7*|*GS 4+4 = 8*|
    \*************|***********|************|********** */
    \\****90%*****|****79%***|****SUSP.***|**BENIGN**/
    \\\*GS 4+3 = 7*|*GS 3+4 = 7*|************|*********/
    \\\\***********|*********APEX***********|********/
    NUC Whole Body Scan/CT Urogram 8/29. BOTH CLEAR
    Prolaris result 9/11 T2b, 3.8/10, 10yr Mort Risk: 23.5%, Metast Risk: 29.6%.
    Consult 9/11 Recom BT/RT/RALP
    Consult RALP 10/12
    DPHC MRI 3T 10/23
    RALP 11/15

  7. #7
    You may want to re-think having surgery. It's a controversial trade-off to have surgery knowing that you must have RT anyway afterwards. RT with HD brachy boost may be a course for you to reconsider. Just my opinion.
    DOB: May 1944
    In Active Surveillance program at Johns Hopkins
    Five biopsies from 2009 to 2014. The third and fourth biopsies were positive with one core and three cores <5% and G 3+3. Fifth biopsy was negative.
    OncotypeDX: 86 percent chance of PCa remaining indolent
    August 2015: tests are stable; no MRI or biopsy this year for my AS program
    August 2016: MRI unchanged from 2/2014; PSA=3.9; FPSA=26; PHI=28. No biopsy necessary.

    A NOTE ON PSA: My readings have been erratic for over 10 years; typically being 3.5-4.2, but spiking to over 10 at times.
    These spikes are asymtomatic to me, and resolve themselves. A prostate biopsy can triple the PSA, which lasts for months.
    Last Free PSA was 26. I don't worry about PSA spikes anymore.

  8. #8
    Regular User
    Join Date
    Aug 2017
    Location
    Troy, MO
    Posts
    34
    Quote Originally Posted by ASAdvocate View Post
    You may want to re-think having surgery. It's a controversial trade-off to have surgery knowing that you must have RT anyway afterwards. RT with HD brachy boost may be a course for you to reconsider. Just my opinion.
    I will see what the MRI shows and further evaluate. Thanks, for your thoughts!
    69 yr. old DOB 4/7/48 Troy MO-just W of St. Louis
    PSA 3.2 7/08 Slightly enlarged
    No PSA DONE w/labs. 2013 due to 0 symptoms-MISTAKE
    PSA 51.2 (7/11/17), 0 symptoms
    DRE hard on left, 31g size (norm 25g) 7/24
    Biopsy 8/11 No PNI
    /////**********|**********BASE**********|********\
    ////***88%****|***66%*****|****6%*****|**PIN****\
    ///*GS 4+4 = 8*|*GS 4+3 = 7*|*GS 4+4 = 8*|**********\
    //************|************|************|**********\
    |*****87%****|***70%*****|****9%*****|***4%*****|
    |**GS 4+4 = 8*|*GS 4+4 = 8*|*GS 3+4 = 7*|*GS 4+4 = 8*|
    \*************|***********|************|********** */
    \\****90%*****|****79%***|****SUSP.***|**BENIGN**/
    \\\*GS 4+3 = 7*|*GS 3+4 = 7*|************|*********/
    \\\\***********|*********APEX***********|********/
    NUC Whole Body Scan/CT Urogram 8/29. BOTH CLEAR
    Prolaris result 9/11 T2b, 3.8/10, 10yr Mort Risk: 23.5%, Metast Risk: 29.6%.
    Consult 9/11 Recom BT/RT/RALP
    Consult RALP 10/12
    DPHC MRI 3T 10/23
    RALP 11/15

  9. #9
    Top User RobLee's Avatar
    Join Date
    Jul 2016
    Location
    Florida Suncoast
    Posts
    725
    Quote Originally Posted by john4803 View Post
    I get a DPHC MRI 3T next Monday. The appointment allows for 80 minutes.

    I had NUC bone scans and CT of the pelvis and abdomen and they were both negative.

    So, those were not enough for him to clearly see the Prostate, apparently?
    MRI's reveal soft tissue in greater detail than CT, and a bone scan is just that, bones.

  10. #10
    Regular User
    Join Date
    Aug 2017
    Location
    Troy, MO
    Posts
    34
    Quote Originally Posted by ASAdvocate View Post
    You may want to re-think having surgery. It's a controversial trade-off to have surgery knowing that you must have RT anyway afterwards. RT with HD brachy boost may be a course for you to reconsider. Just my opinion.
    ASAdvocate,

    Was wondering if there is a 100% guarantee that with Radiation of the Prostate, no cancer can continue to grow and eventually leave the Prostate? As with removal of the Prostate, there should be a 100% guarantee that no cancer will grow and leave it.

    Just some thoughts I am going through.
    69 yr. old DOB 4/7/48 Troy MO-just W of St. Louis
    PSA 3.2 7/08 Slightly enlarged
    No PSA DONE w/labs. 2013 due to 0 symptoms-MISTAKE
    PSA 51.2 (7/11/17), 0 symptoms
    DRE hard on left, 31g size (norm 25g) 7/24
    Biopsy 8/11 No PNI
    /////**********|**********BASE**********|********\
    ////***88%****|***66%*****|****6%*****|**PIN****\
    ///*GS 4+4 = 8*|*GS 4+3 = 7*|*GS 4+4 = 8*|**********\
    //************|************|************|**********\
    |*****87%****|***70%*****|****9%*****|***4%*****|
    |**GS 4+4 = 8*|*GS 4+4 = 8*|*GS 3+4 = 7*|*GS 4+4 = 8*|
    \*************|***********|************|********** */
    \\****90%*****|****79%***|****SUSP.***|**BENIGN**/
    \\\*GS 4+3 = 7*|*GS 3+4 = 7*|************|*********/
    \\\\***********|*********APEX***********|********/
    NUC Whole Body Scan/CT Urogram 8/29. BOTH CLEAR
    Prolaris result 9/11 T2b, 3.8/10, 10yr Mort Risk: 23.5%, Metast Risk: 29.6%.
    Consult 9/11 Recom BT/RT/RALP
    Consult RALP 10/12
    DPHC MRI 3T 10/23
    RALP 11/15

 

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