ANA Discussion Forum
General Category => AN Issues => Topic started by: Nancy Drew on June 18, 2008, 12:33:36 pm
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I have had all five of my MRIs done at the same facility. The same guy does them every time. Different doctors read 1-3, and 4 & 5 were read by the same doc. Doc #2 said the AN was a couple of mm bigger than 1 & 3. Doc didn't catch this until I pointed it out, and he had another doc read it, and he agreed with 1 and 3 docs--no change. Doc 4 said no change, and then same who read 4 said 1mm growth. I looked at the MRIs side by side from the same angle, and I could see the growth and espeically the change in shape. I know people here say measurement can be slightly off, but with my last MRI I had some hearing loss. Do you think I should have MRI #6 done at a different facility? Just wondering if you guys have any ideas?
Nancy
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Nancy -
just came from my doc's office where we discussed my recent MRI.
He reminded me before I left his office that I'll need another MRI next year and he said that it's always a great idea to have your MRIs done in the same place if possible.
So IMO - for what it's worth - you shouldn't switch places for MRI #6.
Jan
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Jan,
I think your doc is probably right. Also I think the doc might send one to a facility that they are pleased with. By the way, that panel of doctors that looked at my MRIs to recommend treatment came back 4 against and 2 for (my doctor included in the treatment decision). AN doc sending me for another opinion so glad he is open enough to question his own decision. I see the new doc June 30th. All of the waiting is what gets me the most. Anxiety, sleep problems, etc. I am sure everyone has been here. Thanks for your support this past month.
Nancy
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Nancy:
I've had a total of 6 MRI's over the past two years and all but one was performed at the same facility (and same MRI unit). My neurosurgeon was satisfied with my first MRI (that 'discovered' my AN) but he operates out of a hospital 30 miles away from my residence and preferred that I have all my MRI's done at that facility for the sake of consistency, as he put it. That seems logical to me so I would concur with the premise that having multiple MRI scans performed on the same unit by the same people is very likely a better choice than going from one facility to another.
Jim
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I have had MRI's in 3 different cities in Texas - initial in Austin and then when I surgery in Houston before I could leave the hospital and then some follow-up where I live now. I like to compare the ammenities that they provide you with: music/no music (music was my favorite), earplugs (only need 1 now!), a little mirror so you can see out...I can't remember what else. I would recommend Austin... ;)
K
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K,
I don't know what I would do without that little mirror. Nice to see the guy working the panel. Creepy inside that thing. Even with the music and earplugs, the sound is just crazy. That in itself makes me think it is going to take out my hearing! Thanks goodness now that they know what they are looking for the MRI doesn't take as long. That first one I was in there over an hour. I don't even think about looking to the side or above or I would panic. The fellow doing mine always says it is a safe place to be in a tornado. Not helpful, but he was trying to be funny to ease the anxiety! Of course, what about being in there if it floods. I don't know how you would get out of that thing!
Nancy
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Hi Nancy,
I had 8 MRI's done at the same place. The first 5 were done with an old machine. For the 6th, the hospital purchased a new MRI machine, which the staff thought was better. My tumor did grow a little that year but I don't really know if the machine was that much better and detected the growth, or it was just growing on it's own. Anyway, the post surgery MRI's were taken there also, showing no residual tumor, that's about the best news anyone can hear! I personally would use the same facility. I wish you the best! Ann
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Hi Nancy (you're my namesake & I'm yours !)
I personally would first, talk to the doctor you feel has the most understanding/knowledge of your MRI's, & ask her/him about the discrepancies; then get the MRI at the same place, with this doctor reading the films.
My pre surg MRI was done at Univ. of Miami. I had my 1 year post surg. MRI at the same place, had it sent to my otoneurology surgeon - he sent it to my neurosurgeon who accurately assessed it. (the radiologist saw a 'tumor' the same size as my pre-surg.- wrong , she didn't see my hx: post AN surg. What she thought was a tumor was the fat placed in the space left by the tumor. ps: Thanks again to those of you who, when I wrote in freaking out about having a 'tumor' that it was really the fat. You guys had experience, there you go! ).
This year I will have my MRI done at the same place, results sent to my PCP & my neurosurgeon - who gives me the answer via email !
Always good thoughts, Nancy
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Nancy~
Believe it or not, I like them (after the intial getting in) and it is kind of soothing - I usually go to sleep or close -- does that tell you anything about my life?? I guess it is just TOO busy running after 3 girlies!! ;D
K
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K,
What's up? I can think of a lot more things that would be soothing than being in that tube. But hey, if it melts your butter and cleans your plow, then go have fun!
Nancy
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Nancy,
I have been doing a fair amount of research into MRI's and simply using the same place / machine does not guarantee you "consistancy".
MRI's vary in terms of strength (measured in Tesla's (T). Most machines vary between 0.5 and 2.0 T's. I think 1.7 T's is the most common used on heads. Any stronger can cause issues. To put it into perspective. A 2.0 T Machine is about 20,000 times stronger than the Earth's magnetic field - a bit scary but harmless to humans "they say".
Anyway, a major variable with the machines is age and software. The software is probably the biggest issue in that they constantly upgrade software (no different to computer products - we just hope they don't use Windows0 (lol).
So you'd need to check out the age of the machine (I would rather use a more modern one), the last time the software was updated and the strength of the machine. For example, a 1.0 T machine would not pick up the same info as a 1.7T machine.
As for reading the films - I ignore the radiographers opinion and rely on the neurosuergeon to tell me - that way, you get a consistant measure.
Laz
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Laz:
You raise valid points but they tend to resonate from the fact that if you have a series of MRI's done (over time) on the same machine, even if it's not new or totally accurate, that will give you an element of consistency in the readings. The software issue is also important but unless your current MRI shows a fairly big discrepancy from the last one (same facility, machine and so on) this shouldn't be a major factor in consistency.
I heartily agree that having the neurosurgeon read the MRI and explain it to you (my neurosurgeon does this) is the best way to obtain an accurate interpretation of the MRI on a regular basis. This is what I do. I almost never read the usually indecipherable written report and the MRI photos are usually unfathomable, too. This is why I simply have the surgeon be my guide. My doctor is careful and cautious and notices the slightest differential in the scan. I had my bi-annual MRI last June. He had me get a follow-up MRI a few months later when the MRI showed my AN appeared to have grown a bit. Turned out, it was simply some post-radiation residual swelling that 'disappeared' by the next MRI. All was well. This showed me that this neurosurgeon leaves nothing to chance and accurately interprets the MRI scans, which are performed at the same facility and machine every time. I consider this consistency - and it works for me. :)
Jim
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I think the thing that has confused me the most through this whole process is what my AN doctor told me after my last MRI in May. He said since there was growth he would have the GK now or in the near future. When I asked him what he would do if it was him, he said he would go ahead with the GK. He even said that he would recommend the same if it was his wife, child, sibling, etc. That is a very bold thing to say, I think. I just got my records to take to the doc who is giving me the second opinion, and it looks as if the chart says I have mild ehearing test. Hopefully I will get more info from the second opinion doc. Nancy
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Nancy -
I'm not sure if your doctor telling you to have GK is bold of him or not - it might just be his style. And in all fairness, it sounds like you did ask him. Lots of patients like doctors to tell them what they should do; sometimes it makes things easier.
My doc was just the opposite; try as I might to have him tell me what to do, he flat out refused. He said that he would tell me everything about my options, but that the option choice was mine - which totally frustrated me initially because I was looking for the easy way out. In time I came to see that my doctor's approach was exactly what I needed - the choice was mine and I was glad I made it.
But that's me. It might not be the same for others.
Jan
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Jan:
It was different for me. By the time my AN was found (via MRI) my tumor was large and pressing on my brainstem, giving me some very noticeable symptoms. With a 4.5 cm AN, radiation was not an option. I resented that at the time as I would have preferred radiation, but when I see the angst so many AN patients suffer when trying to decide what to do (and with whom), I'm almost glad the decision was effectively taken out of my hands. As with you, my doctor was a real pro and the surgery worked out just fine.
Jim
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Jim -
I'm glad you posted your experience since your situation was different from mine. I know there are others here too who really had no treatment choice due to the size of their AN or due to the fact that radiation wasn't a reasonable treatment at the time their AN was diagnosed - I'm thinking those who were diagnosed many years ago.
While you guys are saved the frustration of having to make a treatment decision plus you don't have the problem of second guessing yourself, it must be just as frustrating not to have any choice in your own treatment. Although all of our AN journeys are different - they definitely all include stressful elements.
Jan
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When I initually took my MRI films for my consults, every facility said they were great films and I should always get them there. So I have. But I've noticed sometimes films make my head look large other times its smaller. So I can't compare them.
mema