ANA Discussion Forum
Watch and Wait => For those in the 'watch and wait' status => Topic started by: BRO on February 20, 2011, 09:40:49 pm
On Tuesday this will be my first 6 month follow up MRI since I was told I have an AN on right side. My symptoms are very mild and I have not really had any other symptoms other than moderate tinnitus since my last flare up with double vision, nausea, head aches and moderate tinnitus back last May 2010. The first MRI was done with out contrast so I asked the Dr. if I needed this one to be done with contrast and he said no. It was not necessary unless I just wanted to have it at this time. He can see everything he needs to see with the standard MRI. My AN is 15mm with 6mm being extended out past the bone toward the brain. This is the area of most concern so I am told. I have not sought a 2nd opinion at this time and I feel comfortable with my Dr. I have not had a consult with anyone other than my ENT that diagnosed me. Has anyone else been told that contrast is not necessary at this stage? I hope to remain in the Watch & Wait brigade for a long time if I have no further symptoms.
Hmmmmm, this is interesting. My understanding is that all MRIs for ANs should be with contrast, pre or post treatment. I do know that the shadow of a medium to large AN should show up without contrast, but I have not heard of a doctor saying you do not need the contrast when you have already been diagnosed. There are rare people who react to the Gadolinium dye and people with diseased kidneys should not have it. It is also a more expensive MRI with contrast. Aside from those things, if it were me I would ask for the contrast ..... I cannot tell you what is best for you.
Hopefully someone with more experience and/or knowledge will chime in here about this ..... I am very curious since I know you went to a doctor on the ANA list.
Glad you have had no further symptoms ...... that is good!
Let us know what the MRI shows.
I agree with what Clarice said and in fact I was told by my doctor that they could not see the AN unless they do the contrast. You might want to check it out before doing one without contrast and then finding out they need to do it again.
The contrast dye defiantly enhances the image of the tumor. Having already been diagnosed with an AN, it is hard to understand why they wouldn't
want the best available view. Usually the MRI is ordered with and without contrast. It is not a big deal adding the contrast. I have often wondered why,
once you have been diagnosed that they even do the non-contrast part. Seems to me you would only spend half the time in the tube then. Bryan.
I had an MRI done 3 months after my facial neuroma was debulked, I did not have contrast and the remaining bugger show up. I was called back to have another MRI with contrast a week later because the radiologist wanted a clearer picture so his measurements were more accurate.
I'll join the chorus and concur that you should seriously consider informing your doctor that you want the upcoming MRI scan to be taken with contrast. Your AN is relatively small and new growth could be missed if the scan is taken without contrast. The Gadolinium dye will usually 'light up' the tumor so that it can be clearly seen and measured. I see no reason (aside from an allergy isssue) for an acoustic neuroma observation MRI not to be taken without the 'contrast' dye.
Hey BRO (like the siggie)
I am also a non-contrast person. As you can see from my siggie, I have a very small tumor and it shows up very clearly without contrast. (You can even see the inner structures of the ear with the clarity of the machine.) I did ask my ENT (based on the comments here on the forum) about contrast prior to my first MRI - and similar to your doctor, said it wasn't necessary. This ENT has have great depth of knowledge in AN, surgery and 'watch & wait' protocols (very good LT research) - so his view is valued. The only thing I can think of is the quality/type of the MRI machine (Yardtick and I, both Canadian, and same doctor, same MRI machines at high tech hospitals in Toronto - so we are likely 'one' example, but with very different tumors!)
So, no real help to explain why contrast is the 'gold standard' for the detection of ANs - however, it is not uncommon to have an MRI without the contrast. If I don't have to have a chemical added to my body, and you can still clearly see my small AN - I don't plan on pushing for it. Of note, I have since moved from the Toronto area, and need to connect with a new ENT and a different MRI machine - it will be interesting to find out if the protocol will be contrast here. Since I think it is possible the type/quality/age of the MRI machine may have something to do with the need for the contrast, I guess I won't argue either way.
Good luck on Tuesday (was that today?) - my next MRI should be in July which will be 21 months into my journey - so far, so good.
Don't want to get personal, but are there any concerns about your kidneys? Any history? Any blood tests come back abnormal? They are finding that in people with known kidney problems, it is best not to use contrast dye.
Hey guy's. Thanks so much for the replies. My first follow up MRI showed (without contrast) no growth and when compared side by side on my Dr. computer, it showed very well. I was able to see the AN and the computer had the measurements. There was no change is size or shape. It just looks like a big jelly bean shaped spot. I point blank ask my Dr. why he doesn't think I should have contrast added to make the AN show brighter and clearer. He showed me the scans and told me what we would see different if we added contrast and as I looked at the MRI, (maybe the type machine) but it was very clear what we were looking at and he felt that the quality of the scan was accurate enough to show what we needed to see. The scan only took 5 to 10 minutes instead of 30 and the tech. said that this was very common to do this type scan for most of the Dr. in this area at this stage. So at this point, I feel comfortable with the scan and was told that unless I have symptoms in the next 6 months, we will wait 1 year before we scan again. That's great news, so I guess I'll be hanging around the watch and wait brigade for another year. Thanks so much for the input and I have found this forum to be a great place to learn and make new friends. I hope I am able to help someone by being a member and telling my journey.
Hey Bro, way to go! I can go along with the way your going about things. My next MRI I do believe will be without the dye. I didn`t feel that great after this past one. First one was without contrast, all the rest I had the dye, coming in with all the same deminsions. Unless I get more symptoms or to get more noticeable or bothersome I`m hoping to keep it as simple as possible. Hope my Dr. feels the same way. Feel pretty good going on 4 yrs diognosed and god only knows really how long AN has been with me. Best wishes, Mickey
Congratulations - I find great comfort in reading about the other W&Wers, and their no growth scans. We have several 'old timers' W&W (and not just 'older') on this site, I hope I can walk in their footsteps. Nice of the doctor to explain the contrast vs no contrast philosophy - still can't say I exactly understand, but if it works for you (and for me!), then not sure it really matters.
I was mistaken in my original post - I am now over 2 years into my journey. My first follow MRI was 6 months post-diagnosis, the next one was 9 months and now I am going for 18 months between scans. Hoping for the best, but know it may have grown (but doubt it - very few new symptoms) - will deal with the next step in July!
I would definately get an MRI with contrast. It does matter! My first MRI without contrast didn't show my AN at all. It wasn't until contrast was administered that it lit up. It was 4 years ago when my AN measured 8 x 4 mm. I'd tell your Doctor you want an MRI with contrast. It is your right as the patient handling your own medical care. I have found that I have to be my own medical advocate.