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Thread: MRI and endorectal coil

  1. #11
    I had an MRI a couple of years ago at UPMC for prostate, but they didn't give me an endorectal coil at all. Feel like I missed out, is this something new? The MRI took an hour, and when it was through the technician just came over and told me to get lost , they had nothing further for me that day.
    Nov 2013 PSA 4.2 Biopsy Jan 2014- 1 core positive, 20% Gleason 6, doctor highly reco'ed robotic RP - 2nd opinion at UPMC April 2014, put on active surveillance. 2nd biopsy Feb 2015, results negative. PSA test Feb 2016, 3.5. 3rd Biopsy Feb 2016. 3 positive cores less than 5%, Gleason 6. Octotype DX done April 2016, GPS Score of 24--rated "Low risk". PSA test 8/2016, 3.2. PSA test 1/2018 2.2 (after 7 months of proscar) PSA test 7/2018 2.3

  2. #12
    No, it's old technology for 1.5 Tesla MRIs. A few places still want an ERC with 3 Tesla machines, but they cannot justify the accuracy versus the patient discomfort.
    DOB: May 1944
    In Active Surveillance program at Johns Hopkins
    Strict protocol of tests, including PHI, DRE, MRI, and biopsy.
    Six biopsies from 2009 to 2019. Numbers 1, 2, and 5 were negative. Numbers 3,4, and 6 were positive with 5% Gleason(3+3) found. Last one was Precision Point transperineal.
    PSA 4.4, fPSA 24, PHI 32
    Hopefully, I can remain untreated. So far, so good.

  3. #13
    Top User garyi's Avatar
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    Quote Originally Posted by ASAdvocate View Post
    No, it's old technology for 1.5 Tesla MRIs. A few places still want an ERC with 3 Tesla machines, but they cannot justify the accuracy versus the patient discomfort.
    The National Prostate Cancer Center, in Bethesda, use them with 3T MRI's, and think highly of the results. They 'insisted' I had to have the coil, and they "know a thing or two, because they've seen a thing or two."
    72...LUTS for the past 7 years
    TURP 2/16,
    G3+4 discovered
    3T MRI 5/16
    MRI fusion guided biopsy 6/16
    14 cores; four G 3+3, one G3+4,
    CIPRO antibiotic = C. Diff infection 7/16
    Cured with Vanco for 14 days
    Second 3T MRI 1/17
    Worsened bulging of posterior capsule
    Oncotype DX GPS 3/17, LFP risk 63%, Likelihood of Low
    Grade Disease 81%, Likelihood of Organ Confined 80%
    RALP 7/13/17 Dr. Gonzaglo @ Univ of Miami
    G3+4 Confirmed, Organ confined
    pT2c pNO pMn/a Grade 2
    PSA 0.32 to .54 over 3 months
    DCFPyl PET & ercMRI Scans - 11/17
    A one inch tumor remains in prostate bed = failed surgery
    All met scans clear
    SRT, 2ADT, IMGT 70.2 Gys @1.8 per, completed 5/18
    PSA <.006 9/18, .054 11/18, .070 12/18, .067 2/19
    We'll see....what is not known dwarfs what is thought to be fact

  4. #14
    Quote Originally Posted by garyi View Post
    The National Prostate Cancer Center, in Bethesda, use them with 3T MRI's, and think highly of the results. They 'insisted' I had to have the coil, and they "know a thing or two, because they've seen a thing or two."
    Sung to the tune of Don't Fence Me In.
    69 yr at Dx, BPH x 20 yr, 9 (!) neg. biopsies, PCA3 -
    2013 TURP (90→30 g) then PSA 2x/yr, DRE yearly
    6-06-17 DRE: nodule R, PSA rise, on finasteride: 3.6→4.3
    6-28-17 Biopsy #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 5% RLM
    Bone scan, CTs, X-rays: negative
    8-7-17 Open RP, neg. frozen sections, Duke Regional
    SM EPE LVI SVI LN(16): negative, PNI+, nerves spared
    pT2c pN0 bilat. acinar adenocarcinoma G9 (4+5) 5% of prostate (4.5 x 5 x 4 cm, 64 g)
    11-10-17 Decipher 0.37=Low Risk: 5-yr met risk 2.4%; 10-yr PCa-specific mortality 3.3%
    Dry; ED OK with sildenafil
    9-16-17 (5 weeks) PSA <0.1; Pomi-T (2/day)
    LabCorp uPSA (Roche ECLIA):
    11-28-17 (3 mo. ) 0.010
    02-26-18 (6 mo. ) 0.009
    05-30-18 (9 mo. ) 0.007
    08-27-18 (1 year) 0.018
    09-26-18 (13 mo) 0.013 (checking rise)
    11-26-18 (15 mo) 0.012
    02-25-19 (18 mo) 0.015

  5. #15
    Experienced User
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    What I found awe inspiring in the MRI tube was coils in liquid helium cooled to near absolute zero rotating around me. How could you guys possibly spare thoughts on profane matters like endorectal coils!?

  6. #16
    Quote Originally Posted by garyi View Post
    The National Prostate Cancer Center, in Bethesda, use them with 3T MRI's, and think highly of the results. They 'insisted' I had to have the coil, and they "know a thing or two, because they've seen a thing or two."
    If you mean NIH/NCI, it must be situational. They used one on me 10 years ago with the 3T MRI, but did not on my visit a month ago.
    ProstateBiopsyBlog

  7. #17
    Top User garyi's Avatar
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    Quote Originally Posted by ProstateBiopsyBlog View Post
    If you mean NIH/NCI, it must be situational. They used one on me 10 years ago with the 3T MRI, but did not on my visit a month ago.
    Just my luck

    Yes, the NIH/NCI.
    72...LUTS for the past 7 years
    TURP 2/16,
    G3+4 discovered
    3T MRI 5/16
    MRI fusion guided biopsy 6/16
    14 cores; four G 3+3, one G3+4,
    CIPRO antibiotic = C. Diff infection 7/16
    Cured with Vanco for 14 days
    Second 3T MRI 1/17
    Worsened bulging of posterior capsule
    Oncotype DX GPS 3/17, LFP risk 63%, Likelihood of Low
    Grade Disease 81%, Likelihood of Organ Confined 80%
    RALP 7/13/17 Dr. Gonzaglo @ Univ of Miami
    G3+4 Confirmed, Organ confined
    pT2c pNO pMn/a Grade 2
    PSA 0.32 to .54 over 3 months
    DCFPyl PET & ercMRI Scans - 11/17
    A one inch tumor remains in prostate bed = failed surgery
    All met scans clear
    SRT, 2ADT, IMGT 70.2 Gys @1.8 per, completed 5/18
    PSA <.006 9/18, .054 11/18, .070 12/18, .067 2/19
    We'll see....what is not known dwarfs what is thought to be fact

  8. #18
    Garyi, Johns Hopkins stopped using the ERCís in 2012 when they upgraded to 3T machines.

    Since JH and NIH work closely together, your situation surprises me. Guess you drew the wrong straw.

  9. #19
    Top User garyi's Avatar
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    Quote Originally Posted by ASAdvocate View Post
    Garyi, Johns Hopkins stopped using the ERC’s in 2012 when they upgraded to 3T machines.

    Since JH and NIH work closely together, your situation surprises me. Guess you drew the wrong straw.
    Or maybe the wrong plug

    The erc was part of the protocol for the DCFPyl PET Scan Clinical Trial in 2017. I was told because it had the highest sensitivity. I actually fell asleep during the MRI.

    Like just about everything regarding this disease....who knows for sure.
    72...LUTS for the past 7 years
    TURP 2/16,
    G3+4 discovered
    3T MRI 5/16
    MRI fusion guided biopsy 6/16
    14 cores; four G 3+3, one G3+4,
    CIPRO antibiotic = C. Diff infection 7/16
    Cured with Vanco for 14 days
    Second 3T MRI 1/17
    Worsened bulging of posterior capsule
    Oncotype DX GPS 3/17, LFP risk 63%, Likelihood of Low
    Grade Disease 81%, Likelihood of Organ Confined 80%
    RALP 7/13/17 Dr. Gonzaglo @ Univ of Miami
    G3+4 Confirmed, Organ confined
    pT2c pNO pMn/a Grade 2
    PSA 0.32 to .54 over 3 months
    DCFPyl PET & ercMRI Scans - 11/17
    A one inch tumor remains in prostate bed = failed surgery
    All met scans clear
    SRT, 2ADT, IMGT 70.2 Gys @1.8 per, completed 5/18
    PSA <.006 9/18, .054 11/18, .070 12/18, .067 2/19
    We'll see....what is not known dwarfs what is thought to be fact

  10. #20
    Quote Originally Posted by garyi View Post
    Or maybe the wrong plug

    The erc was part of the protocol for the DCFPyl PET Scan Clinical Trial in 2017. I was told because it had the highest sensitivity. I actually fell asleep during the MRI.

    Like just about everything regarding this disease....who knows for sure.
    They never let me fall asleep during the MRI's. Wake up and Breath!! Whatever. The coil thing was painful only because tech didn't understand my anguish "it won't go in any further!!"... Basic anatomy. It lasted about an hour, I guess I moved or shifted, so I had a repeat. Yay!! It's been 3 years now since, but I remember the blood that covered the towel when they pulled it out. "call us back tomorrow if you have a fever...." I thought the tech (and so did she) punctured my rectum.... guess not. But it's good news so far so. Only distant memory...
    YOB 1957, Age at Dx 57. Pre-surgery psa 5.9, 5-27-2014 RP, T2c, 3 G7 (3+4), 4 G6 (3+3). 50% involved. Prostate 28g. +2 margins (lateral, apical). Post surgery psa <.006, 19 month psa 0.023 on 12-16-15.
    70gy/35 SRT finished 2-16. 3 mo Post SRT Psa on 4-16-16 0.02 (no change), 6 mo 0.009, 9 mo .006, 12 mo .008, 15 mo and currently <.006

 

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