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Thread: MRI and endorectal coil

  1. #1
    Experienced User
    Join Date
    Feb 2019
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    64

    Wink MRI and endorectal coil

    FBs,

    I'm headed to MD Anderson for an MRI and consultation. I learned that I will have an endorectal coil for the MRI.

    Thankfully, I was knocked out for the biopsy as I don't think I would have handled that process very well awake.

    Can anyone tell me about the coil? They said there will be a balloon around it that they will inflate. How large is the coil? How uncomfortable is this process? I'm having scans with and without contrast so I think I will be in there for awhile.

    Should I ask for something to relax me? They said I could ask for something to relax me if I was claustrophobic and they could do it under general anesthesia if required. I don't want to wig out as squirming around will not be an option.

    On one level I find these questions completely hilarious. I know I'm going to have surgery at some point and will likely have some pre-surgical/post-surgical treatment, but I'm a little squeamish about having a probe and balloon in place for what could be over an hour.



    Thanks,

    Josey
    DOB 6/27/69
    12/21/18 1st PSA 25
    1/9/19 PSA 21.7, Free 1.86
    1/17/19 TRUS biopsy:
    PNI+ on left
    MD Anderson review of slides: 12/12 cores positive
    RB 55% 3+4=7
    RM 29% 3+3=6
    RA 12% 3+4=7
    LB 44% 4+3=7
    LM 84% 4+3=7
    LA 100% 3+4=7
    RBL 2% 3+4=7
    RML 24% 3+4=7
    RAL 26% 3+4=7
    LBL 87% 4+3=7
    LML 100% 4+3=7
    LAL 100% 4+3=7
    CT and bone scans negative
    MRI: NVI, SVI, rectum, bladder neck, sphincter, LNs: negative
    EPE negative, however, lesion in left peripheral gland abuts capsule along the left anterior,
    lateral and posterior lateral aspect of the gland.
    4/9/19 Began 6 months Lupron + Zytiga
    PSA 5/7/19 2.3
    PSA 5/24/19 1.3

  2. #2
    Top User garyi's Avatar
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    Apr 2017
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    1,172
    Quote Originally Posted by joseywales View Post
    FBs,
    ......I'm a little squeamish about having a probe and balloon in place for what could be over an hour.


    Josey
    Not to worry, Josey. Not too big, it's behind you so don't look, well lubricated, 15 or 20 minutes max, a much more accurate ercMRI.....and if you're nice, they send you flowers.

    I got a pill to relax me, it's still in my medicine cabinet. You should be fine.
    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, .078 5/19
    We'll see....what is not known dwarfs what is thought to be fact

  3. #3
    Senior User
    Join Date
    Jan 2019
    Posts
    310
    The big thing is to get very comfortable on the table. They help with pillows, stick some headsets on you, play you a tune. Close your eyes and Relax.
    DOB 5/1957

    PSA - 11/2010=1.9, 6/12=2.3, 12/13=2.19, 12/14=2.64, 3/17=5.29, 3/17=3.91, 6/17=3.47, 12/17=4.50, 12/17=3.80, free PSA low risk (local (Uro, ďMy opinion you donít have cancer), 8/18=5.13, 10/18=5.1, 10/19 ISO PSA 56% risk cancer. All DREs negative.

    DX 12/18, GS 8, 4+4 6/12 cores, LL Apex 100%, LM Apex 60%, LL Mid 50%, LMM 40%, LL Base 5%, LM <5%, Right side negative, (Uro opinion ďThis has been going on for a yearĒ.... ah, more like 2 years ). Bone scan/CT negative

    2/25/19 R-LESS (Robotic Laparoendoscopic Single Site Surgery) outpatient Cleveland Clinic,

    3/6/19. Pathology - Grade Group 4 with Intraductal Carinoma
    T3aNO, GS8, unifocal tumor 10%. -7 Nodes, - SV, - Margins, - PNI,
    - bladder neck neg., + EPE non focal apex/mid lateral 1mm max extension, Cribriform pattern present. Decipher .86 High Risk. 38% risk 5 year metastasis.

    PSA 3/27/19 .03. (29 days)
    4/25/19 <.03. (58 days)
    5/25/19 <.02. (88 days)

    ADT started 6/3/2019

  4. #4
    Senior User
    Join Date
    Nov 2018
    Posts
    206
    Mine was 45 minutes. Not very comfortable but if relax and stay still it's tolerable. They do put headphones on you to listen to music.

  5. #5
    Experienced User
    Join Date
    Feb 2019
    Posts
    64
    Gary and Duck,

    Thanks for the information.

    Flowers would be nice.

    One of my friends said, "Hey, are they going to buy you dinner and take you to a movie first?"

    I commented that the combination of 'latex' and 'endorectal' had me thinking Fifty Shades of Grey.

    He said, " I can't believe things are going so far on the first date."

    We may be in our late 40's but still have college age humor going for us.



    On another note, the nurse said it will be a 3T MRI and that gives the best definition.



    Take care,

    Josey
    DOB 6/27/69
    12/21/18 1st PSA 25
    1/9/19 PSA 21.7, Free 1.86
    1/17/19 TRUS biopsy:
    PNI+ on left
    MD Anderson review of slides: 12/12 cores positive
    RB 55% 3+4=7
    RM 29% 3+3=6
    RA 12% 3+4=7
    LB 44% 4+3=7
    LM 84% 4+3=7
    LA 100% 3+4=7
    RBL 2% 3+4=7
    RML 24% 3+4=7
    RAL 26% 3+4=7
    LBL 87% 4+3=7
    LML 100% 4+3=7
    LAL 100% 4+3=7
    CT and bone scans negative
    MRI: NVI, SVI, rectum, bladder neck, sphincter, LNs: negative
    EPE negative, however, lesion in left peripheral gland abuts capsule along the left anterior,
    lateral and posterior lateral aspect of the gland.
    4/9/19 Began 6 months Lupron + Zytiga
    PSA 5/7/19 2.3
    PSA 5/24/19 1.3

  6. #6
    Senior User
    Join Date
    Feb 2017
    Posts
    142
    As advertised, the key is to just relax. It is uncomfortable rather than painful.

  7. #7
    Regular User
    Join Date
    Jan 2018
    Posts
    32
    I had one many years ago. The insertion was pretty uncomfortable, but once it was "in," I relaxed and it was fine.

    I mainly recall that a nurse came to be before and asked if I knew how this procedure was going to be done. I did, but asked "Are there people who come here and don't realize what's about to happen?" She said yes, and I can just imagine the wide-eyed look on someone who shows up for an MRI and finds out right before about the "coil."
    Age 63
    Diagnosed with PC in December 2015 based on saturation biopsy
    2 positive cores, Gleason 6, both under 10%
    Currently on AS
    All MRIs negative, both before and after diagnosis
    Three post-diagnosis biopsies, two negative, one positive, with two cores of Gleason 6, both under 10%.

  8. #8
    I had one for my first (of five) MRIs at Johns Hopkins. It was a 1.5 Tesla machine. I found it excrusiatingly painful.

    Since 2013, when they installed the 3T machines, they no longer use the ERC, but rather an apron coil. JH believes that is produces equal images without "patient discomfort".

    But, that is my experience. I replied to a man on another forum a few months ago about awful my pain had been. He then had an MRI with ERC and posted a thread attacking me for terrifying him unnecessarily. He said it was merely uncomfortable for him.

    So, every man's experience is different. But, nobody has EVER complained about the apron coil.
    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.

  9. #9
    Quote Originally Posted by joseywales View Post
    We may be in our late 40's but still have college age humor going for us.
    Between residents, physicians and a nurse who did my PCA3 "massage", from fingers to coils to ultrasound probes, I often say "Moon River" when something goes in. So far, no one has ever commented or chuckled about the Fletch reference...

    I had a 3T MRI with ERC about 10 years ago. I did not have pain, but it wasn't pleasant, either. I would also say tolerable, the worst part being it took about an hour or so. I am happy to say on my recent return visit, the NIH/NCI did not use an ERC and it only took about half the time.
    ProstateBiopsyBlog

  10. #10
    Experienced User
    Join Date
    Feb 2019
    Posts
    64
    FBs,

    I had my MRI at MD Anderson today. They need to make the Endorectal Coil in extra small! Iím a little guy who weighs in at 122lbs. That thing really hurt going in! Removal wasnít a party either. Itís done though. Tomorrow I meet with the urologist at 9:00 and an oncologist at 1:00. Soon I will have more data points and additional opinions.

    Iíll log in tomorrow with an update.


    Josey

 

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