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Misreading of MRI?

mikew42
Posts: 113
Joined: Mar 2004

I had an appointment last Friday with my oncologist to discuss my latest MRI/CT scans. My CT scan showed no tumors in the lungs, the MRI showed no growth or reduction in liver tumor from May (still 1 cm). It had shrunk 50% on last MRI. My oncologist started the appointment by saying "I'm a little puzzled by the MRI, I don't see what the radiologist sees". He is apparently having a hard time seeing the tumor on the liver and admitted that he didn't look at the last MRI, he just took the 50% reduction for granted. He went back and looked at that scan and doesn't see it there either. He is not convinced that it is actually there and wants to do another round (3 weeks of chemo) and then do a PET scan. If it shows the tumor is still alive, I will have resection, if not alive we will finish the last round of chemo and I will be done. Here's the question, has anyone had misreadings of the scans by the radiologists? They see so many of them that I think they would be more accurate. Of course I am hoping that they are wrong and the tumor is gone (wishful thinking). Mike

scouty's picture
scouty
Posts: 1973
Joined: Apr 2004

Great question Mike!!!!

I am slowly learning that all this science that the docs refer to is not all it is cracked up to be. They are just tests and the results are interpreted by the experts. That is where the scary part comes in, interpreting the results. Sure they see them much more then you and I and yes they are the experts but too often they are "surprised". It is not an exact science yet and the best guessing game is usually what they do. Too often, they rely on emails and reports instead of good ole human to human conversation. My latest tests, the radiologists sent a shot of one of my lymph nodes and my onc was surprised by it since he thought it looked very normal. After I pressed him on whether he thought I had lymph node involvement or not, he finally called the radiologist on the phone. Then we find out, it was sent as a sample of all of my lymph nodes, all looked very normal and cancer free. While that was good news to hear, I wonder what my onc would have thought had he not taken the time to phone the radiologist. Push them, ask them specific questions; like has your onc called and talked to the radiologists about your results.....make them talk to each other and then communicate to you.

I am slowly learning how to take control of my situation instead of totally relying on the "experts". We are all humans and can make mistakes. That is why we need each other daily. Be a part of your treatments!!!! You are so smart to ask the real experts, survivors!!!!!!

Your results sound encouraging either way!!!! You keep up the good fight Mike!!!!!

Lisa P.

jana11
Posts: 708
Joined: May 2004

Hi Mike, I am a cancer surviver AND a doctor. The radiologist reading is subjective. Ones with more experience are better - certain radiologists see more/ report more.

I practice in Houston and get my care at MDAnderson. The radiologist at MDA often see MUCH more than other doctors, simply because they get more exposure to cancers images.

Don't loose the faith. Get a good doctor and ask good questions. Medicine isn't perfect, it is an art. Unfortunately, nothing about cancer is simple, absolute, or easy.

Some radiologist are more accurate than others. If your onc isn't sure - ask for another radiologist to look at the films.

Be well, jana

KrisS
Posts: 232
Joined: Apr 2003

Mike- Yes, there are occasions where radiologists interpretations of the apprearance is incorrect, just as there are differences in opinions among medical oncologists about treatment. Medical oncologists have lots of experience reviewing CT scans with radiologists. Abdominal MRI is a more recent technique, however. Radiologists spend 4 yrs training to look at imaging studies, while medical oncologists spend their time learning how to treat cancer. Somehow I would not feel comfortable with the oncologist second guessing the radiologist without him going down and talking with him/her.

I do hope for your sake that your medical oncologist is correct.

Best wishes,

Kris

carmen07
Posts: 120
Joined: Apr 2004

Mike
I do know when we switch hospitals they would not use our first hospitals CT Scans or Pet Scans for comparison because they told us that each radiologist interpretation is different.
They knew how their radiologist read the test.
Before hubby's surgery of liver we asked for written copies of the Cat/Pet scan test for our own records. In that report the radiologist states what the lesion was in recent Scan and also did comparison of prior. Did not do camparison of Pet Scan since it came from previous hospital. So it just states no comparison.
I agree with Jana that your onclogist should ask another radiologist to look at your films.
If you don't get answers than I would send them out for a second opinion. Our you at a large Cancer Center??

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