Author Topic: Doctor says 1-year follow up MRI shows no change  (Read 8014 times)

Nancy Drew

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Re: Doctor says 1-year follow up MRI shows no change
« Reply #15 on: July 13, 2008, 11:29:19 am »
Hi Ted,

Thanks for the info.  Just curious though.  I understand the fact that measurements can be off a bit here and there just by the way they are measured.    In my case MRIs 1, 2, and 4 were off only .1mm here and there, and the doctor said this didn't mean anything--no growth  However, the neurologist for my third AN said the AN had gone from 7 mm. to 9 mm.  On this AN I think my doc only looked at the films because I pointed out from the written report that there was a 2 mm. change, and he said that didn't seem right to him.  He showed the MRI to some other docs, and they all agreed that the tumor had not grown.  All of my MRIs have been done at the same facility and done by the same person.  MRIs 1-3 were fillms.  MRIs 4-5 were on CDs.  It was clear that MRI 5 showed that the AN was a totally different shape.  It went from a half moon size to a full moon size.  My doc wanted to do GK since there had been growth (even though it was a small rate of growth), but he also said it was a canidate for W & W also--my choice.  A panel of five other docs from various fields have reviewed all of the MRIs, and they agreed that the AN had grown.  I went to see another doctor for a second opinion about the possibility of having GK or W & W.  The doc looked at the written report only and right away said, no growth and continue to W & W.  However, when he looked at the fillms and CDs he said, "I change my mind.  The AN has grown although only slightly."  He said it is a canidate for either GK or W & W, but in his opinion he would continue to W & W.  So, at this point, I am W & W until my next MRI in Nov. and then going from there as to what to do.  My doc and the 2nd opinion doc said all of the MRIs were excellent pictures from all angles.  I guess I am wondering if just by looking at the shape means anything.  Seven docs have looked at the MRIs and compared them all and agreed that the last MRI showed growth.  What is your thought on this--measurement vs. looking at the dang thing?  I hope I have explained this good enough to get an answer to my question.  Thanks.

Nancy   
12/05 AN diagnosed left ear 4.5mm
06/08 6mm
Gamma Knife 10/21/08
1 year MRI  6.8mm x 5.5mm
2 year MRI  5.9mm x 4.9mm
3 year MRI  6.5mm x 6.0mm 
Slight Hearing Loss Post GK

Swedish Gamma Knife Center
Englewood, CO
Dr. Robert Feehs

Ted A

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Re: Doctor says 1-year follow up MRI shows no change
« Reply #16 on: July 16, 2008, 10:23:43 am »
Hi Nancy:

I am not qualified to judge in your particular case. However, what I have learned from my experience is to:

- find a doctor who you trust and who uses a radiologist he/she trusts
- have the MRIs at the same facility or hospital using the same machine
- have the radiologist or doctor meaure three dimensions of the AN in the same way
- have them measure a benchmark (known organ of fixed length in the MRI field) to be sure the length scale is constant.

It sounds like MRIs may have issues with accuracy and precision. One way to guard against this problem is with consistent measurements.

Regards,
Ted A