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new subject - and question

CAMaura
Posts: 719
Joined: Feb 2005

Hey -
I have a question or two about methods to classify findings - you know, like: Does the MRI show as much or more than the CT? Is it useful when the CT is still showing the possibility of something?
To back-up, I had a CT in November that was questionable: a nodule on my lung and a lesion on my liver that had grown a bit. I was nervous as could be for three months and had the CT repeated (I had no previous CT of my lung only X-rays). The lung nodule is not changed at all and my hope is that it is just something that is inherent to my body. The liver lesion is unchanged from its new size of three months ago - but it is bigger than the previous year which still has me anxious; it might be a hemangioma, but it could also be something bad. Two other liver-lesions have been classified as cysts (through ultrasounds that I pressed for).
My CEA has been consistently super low - and it has worked with my body - so I am happy about that, but I would like to try to figure this thing out. The radiologist called for another 3-6mos. repeated CT and, if possible, I would like to limit the CTs. I have to be on my game with my oncologist (to keep him on his game).
Okay, thanks for the input. I appreciate any comments.
All the best, Maura

chynabear's picture
chynabear
Posts: 483
Joined: Jul 2005

To understanding, a PET scan is the best for determining whether something suspicious on a CT scan or MRI is something to worry about.

As far as the MRI, I have never had one and won't pretend to know much about it. I know my insurance company told me that they would only pay for a PET scan if the CT OR the MRI show something suspicious. In my mind, that made then equals... but not sure.

If it were me, I'd insist on a PET to see if there is any uptake of the radioactive glucose.

I pray that it is nothing to worry about. I hate the waiting game!

Take Care,

Tricia

shmurciakova's picture
shmurciakova
Posts: 910
Joined: Dec 2002

Hi Maura,
Speaking from experience here, if the questionable spots are greater than or equal to 1cm in size, then I would get a PET scan. If they are smaller, you could get a false negative result. I had 2 false negatives before my lung nodules became large enought to light up on the PET.
An MRI is normally used, at least from what my docs have said, for someone who is pregnant or should not be exposed to any radiation. It is slower, but does still give good results. To confirm CT results, a PET scan should be done. If the nodules are very small though, unfortunately the wait and see approach is all that can be done, unless you want to go ahead and have a biopsy (removed)...Unless your CEA is rising, I would not be too concerned about it.
Good luck,
Susan

Betsydoglover's picture
Betsydoglover
Posts: 1210
Joined: Jul 2005

Hi Maura -

In March and April 2006 I was evaluated at NIH for a clinical trial at NIH that involved RFA. I had 3 MRI's in addition to PET and CT scans each time.

When I was referred back to my regular oncologist I asked her if MRI's should be part of the regular testing regimen. She told me that the MRI's done at NIH were great for visualizing blood vessels and the location of any tumors relative to blood vessels (which would have been important for RFA - if in fact they found any tumors). She also said that if PET scan was not available, she would consider MRI as another layer of truth on top of CT, but given the availability of PET, she did not think that MRI was at all needed in the absence of a need to see the tumor with respect to blood vessels.

Hope this helps - I would push for a PET scan - hopefully it would give you a more definitive answer about the "lesion / nodule" that shows up on CT.

Take care,
Betsy

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

Hi Maura,

I am so sorry you are going thru the horrid fear "stuff" and I pray you get good news soon so you can relax some.

When I became allergic to the IV contrast and the meds didn't make a difference, my onc and I had to decide what testing I would do going forward. I have never had a PET so he discouraged that since I have no benchmark and all sorts of stuff could "light up" scaring the crap out of me. So I will have chest x-rays and an MRI. Also last year when I had my surgery to reverse my colostomy bag, my GI oncological surgeon wanted an MRI after a CT to check out my liver to make sure my mets had really gone away.

So you have another opinion and again I hope you get good news SOON!!!!!!

Lisa P.

taraHK
Posts: 1961
Joined: Aug 2003

Hi Maura,
I don't have any experience with MRI but (unfortunately!) I have quite a lot of experience with CT and PET. I agree with Susan (shmurciakova) that, if the lesions are of a certain size, you might want to explore the option of PET. That shd give a fairly good indication of whether they are benign or malignant. I thought 1 cm was the cut-off too but more recently I heard it could be smaller. Perhaps this depends on the specific technology available at any given center. You could ask your oncologist/radiologist. I had a lung nodule "light up" which was smaller than 1 cm.
The waiting is very hard. "Feed the faith, starve the fear". Many nodules in the lung and in the lesion are benign.
Thinking of you and sending best wishes your way.
Tara

taraHK
Posts: 1961
Joined: Aug 2003

Hi Maura,
I don't have any experience with MRI but (unfortunately!) I have quite a lot of experience with CT and PET. I agree with Susan (shmurciakova) that, if the lesions are of a certain size, you might want to explore the option of PET. That shd give a fairly good indication of whether they are benign or malignant. I thought 1 cm was the cut-off too but more recently I heard it could be smaller. Perhaps this depends on the specific technology available at any given center. You could ask your oncologist/radiologist. I had a lung nodule "light up" which was smaller than 1 cm.
The waiting is very hard. "Feed the faith, starve the fear". Many nodules in the lung and in the lesion are benign.
Thinking of you and sending best wishes your way.
Tara

CAMaura
Posts: 719
Joined: Feb 2005

Thanks - all of you - for your responses. I tend to be the type of person on-site who tries to give good thoughts but is not always one to venture into the field of asking for help...so, thanks again - so much appreciated.
To be honest, I have heard lots of goofy stuff about PET scans - the false positive, false negative stuff . I still wonder (and hate the word radioactive dye) but I will ask. I will also ask about the MRI. Quite frankly, I am happy to push for both if needed.
In the meantime, I have tired to boost my nutrition-side of things. It is sometimes hard to stick to every day but I hope to be boosting my immune system: added herbs, mushroom extracts, and really trying to not miss very many days of juicing...
As for the worry, thank you for your good thoughts. With a lot of candor as much as sincerilty, now knowing sucks.
I see my onc next week and will have a frank talk with him. I certainly want some sort of confirming tests done. It makes no sense to just wait this out while something might be growning...
Again, thanks so much and of course I am wishing all of you well - Maura

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