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Re: FYI: A Warning about Misinformation on an MRI following a Biopsy

Alan,
I was wondering why you wanted to get the MRI after the biopsy rather than before. In my case I was on AS for 3 years and my PSA kept rising. My uro's non-targeted biospies sometimes found very small GS6 or at other times nothing at all. I asked about a CDU or MRI and he gave them no credibility at all. Luckily our local cancer center installed a new MRI program (non-coil) called VividLook. I had the MRI done and using those images a new uro found a GS8 tumor for which I sought treatment. I wanted the MRI done prior to the biopsy since I suspected my tumor might have been in a place difficult to access. (It wasn't--my old uro was a bad shot I guess)

Re: FYI: A Warning about Misinformation on an MRI following a Biopsy

Joe,

If I am interpreting your post correctly, you had an MRI guided biopsy where your Gleason 8 tumor was detected and then biopsied in the same procedure. Essentially, I had a similar "targeted" biopsy done, except that it was done with the aid of a CDU scan designed to show the location of the tumor or tumors. Dr. Bahn then used this scan to inject a biopsy needle into the heart of the tumor that he did find in order to be able to better determine its true Gleason grade. I also had him biopsy other areas even though no tumor was visible on the scan in those places. Of particular interest to me was the area of the prostate near the left neurovascular bundle and left seminal vesicle since they are common pathways out of the gland. As I said in my post, the biopsy did pick up a small tumor that the scan missed which is right up against, but not outside of the capsule in the area of the left neurovascular bundle.

So, it seems to me Joe that we both had a scan and biopsy in the same procedure, with the only difference being that I scheduled an additional scan (meaning the MRI) after. The inability to read the MRI results was simply due to scheduling the appointment too close to the biopsy based upon bad advice from three different hospitals. I was in no hurry after the biopsy to schedule that appointment. If even one of the three hospitals had advised me to wait a certain number weeks for my prostate to heal, I certainly would have done that. In fact, I am the type of guy who would take into account the number of weeks I was told to wait and tack on a couple of more just to be on the safe side. However, as you know from reading my post, all three hospitals said that no waiting period was necessary. At the time, since it came from three different sources, there was no reason to believe that they were wrong. Since I did not want others to go through the same experience, I posted my warning.

I hope I have answered your question Joe. Feel free to write me back if I did not.

All the best,
Alan M in USA

Re: FYI: A Warning about Misinformation on an MRI following a Biopsy

Alan,
Thanks for the clarification. Actually, mine was a bit different. I was planning to fly out to CA (I live in NC) and get a targeted biopsy from Dr Bahn, when I found out that my local hospital had a new MRI that was supposed to be able to spot PCa tumors. The MRI and biopsy were not done at the same procedure. The MRI was done first and created a CD containing a series of scans which clearly showed the tumor. Using these pictures as a guide, my new uro was able to put 6 cores into a small 1cc tumor. My biopsy was "targeted" but not "real-time" targeted like Dr Bahn and his CDU.

Re: FYI: A Warning about Misinformation on an MRI following a Biopsy

Alan,
I would go back to the doctor/department who gave you the MRI & demand a second MRI at no cost because the first scans are unuseable.
I feel that your case would be stronger if you remember who said that it's OK to have the MRI
and if the radiologist had in your file the date of your biopsy and yet still went ahead & gave you the MRI. If they won't refund your complete $4000,
maybe they'll give you a 50% reduction.
Doug

Re: FYI: A Warning about Misinformation on an MRI following a Biopsy

Hi Doug,

Thanks for the advice, which I'm going to follow through on. I found this passage on the following website which I am going to use as the basis of my argument: www.radiologyinfo.org/en/info.cfm?pg=mr_prostate

"MRI cannot always distinguish between cancer tissue and inflammation or presence of blood products within the prostate, which sometimes occurs related to a prostate biopsy. To avoid confusing the latter with the former on imaging, prostate MRI should be performed more than six to eight weeks after prostate biopsy, if possible, to allow remnants of bleeding to resolve."

If I fail, it won't be for lack of trying (and, at the very least, I'll still be thankful that the cost did not come out of my own pocket). Wish me luck.

Alan M in the USA

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