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3T MRI-S as an alternative to biopsy

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Posted 11/7/2011 9:20 PM (GMT 0)

With a 2 member family history of Prostate Cancer (father and brother) the initial increase in my PSA prompted a 20 core biopsy.  All cores were negative for PC.  PSA test at the 6 month follow up showed a rapid rise from 6.15 to 13.3.  Urologist suggested probably Prostatitis and prescribed three weeks of CIPRO.  PSA after the CIPRO was 18.1.  No explanation, wants to take another biopsy "In case we missed something.' 

I'm looking for alternatives as I believe that the trauma to the prostate gland may well be responsible for MY strange PSA results.  During my research, I've found references to the 3 Telsa MRI-S as a diagnostic tool.  Beth Israel Deaconess Medical Center in Boston is using this supped-up MRI for this purpose as well as some other centers.

Does anyone have any experience with this diagnostic method? 

Good or bad would be appreciated.

I don't plan on letting the urologist with no information continue to use my prostate as a pin cushion!

Thanks,

Posted 11/7/2011 9:37 PM (GMT 0)
PSA-rocket,

I can't offer comments, since my first biopsy was a "winner" on 9 of 12 cores (lucky me   sad ), and I didn't do much advanced screening. There are other members here who know a lot about the subject test, and I'm sure you'll walk away with a lot of information.

Just wanted to give you a Welcome to HW, and an invite to come back often to keep us posted, or just an electronic scream if need be.

Posted 11/7/2011 9:50 PM (GMT 0)
Some guys here swear by color doppler ultrasound but the facilities are few and far in between. The 3T MRI is new and I have little reference other than the presentations I saw. Sounds positive but that's not the results you want...pardon the pun...lol. I have a guy in our live support group that tested negative with color doppler and his saturation biopsy found the cancer after his PSA peeked up to 20.

John T here has a similar story to yours and he had a successful Dx with color doppler. I'm certain he'll be checking in soon...

Tony
Posted 11/7/2011 10:49 PM (GMT 0)
Rocket,
I had a 1.5T MRIS, a 3T MRI, and and two color dopplers. All of these after 12 negative biopsies over a 10 year period.

The 1.5 MRIS showed negative; both color dopplers showed a suspicious area that was targeted for biopsy and was positive in 3 of 3 cores. The 3T MRI confirmed the 2.5 cm tumor.

I think the color doppler has advantages if done by an expert; it is way less expensive and a biopsy can be done at the same time, guided to the suspect area. I would not waste my time with a 1.5T mri.

With the high psa and a negative biopsy I would suspect a transitional zone tumor as they generate much higher psa for their size and are very difficult to biopsy by conventional methods. There are two color doppler radiologists that are expert in finding transition zone or anterior tumors; Dr Duke Bahn in Ventura Ca and Dr Fred Lee in Rochester MI.
If you have to get a biopsy after the MRIS identifies an anterior tumor a regular urologist will have a difficult time biopsing it. I'm not aware that a biopsy can be guided by an MRI at this time. Drs Lee and Bahn are very good at biopsying areas that are difficult to reach.
As one radiologist aptly said " It's not the arrow, but the Indian." The radiologist looking at the image is more important than the technology. Both Bahn and Lee have done over 20,000 biopsies each so they know what they are looking at.
If I had an MRIS I would be sure to get the best radiologist that has thousands of experiences looking at prostates. Some instutitions like UCSF in the past had interns reading the images. They also look at many other cancers and prostates are usually not their area of expertise.
JohnT
Posted 11/8/2011 2:32 AM (GMT 0)
JohnT

Thanks for the info, would only consider 3T at a specialized facility, I was looking at Beth Israel Deaconess in Boston, they appear to have been very involved in the development of the 3T MRI S methodology. I'll have do look deeper into the Doppler ultrasound, don't know much about it.

Thanks again.

Rocket
Posted 11/8/2011 6:20 PM (GMT 0)
Well guys, the Rocket just took a dive.

In a routine physical today, a PSA test had it dropping from 18.1 to 6.4 in 60 days. Urologist cancelled the scheduled biopsy and internist said this demonstrates what a poor test the PSA really is. They have no explanation of the erratic behavior of the PSA results.

So, hopefully you won't be hearing from me anytime soon.

Rocket
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