Re: MRI as a Screening Tool?

[Guest guest]

Hi you ask:

<snip> Can an MRI examination be

used as a screening tool when the patient has high PSA numbers and a negative

biopsy?...... What am I missing? <snip>

MRI is a very ineffective screening/scanning

tool for prostate cancer with high false positive and false negative readings.

One web doctor famously said you’d get a similar result if you tossed a

coin. My original oncologist told me that the ‘echo’ from the tumour

was poor and that was the main problem.

All the best

Terry Herbert

I have no medical

qualifications but I was diagnosed in ‘96: and have learned a bit since

then.

My sites are at www.yananow.net  and www.prostatecancerwatchfulwaiting.co.za 

Dr

“Snuffy” Myers : " As a physician, I am painfully aware that most of

the decisions we make with regard to prostate cancer are made with inadequate

data "

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of Larsen

Sent: Saturday, 5 January 2008

7:40 PM

To: ProstateCancerSupport

Subject: MRI

as a Screening Tool?

Can an MRI examination be used as a screening tool

when the patient has high PSA

numbers and a negative biopsy? I have been reading the postings to this group

for

months now. I know the importance of an early detection. I also know that

biopsies can

miss. While MRI examinations are used after a positive biopsy, I don't read of

any cases

where a patient with consistent elevated PSA readings and negative biopsies

then

undergoes an MRI for the discovery of the cancer. How come? What am I missing?

[Guest guest]

PCa is not the only cause of elevated PSA. Prostatitis is also a cause. That should be investigated and treated first before going through the expense of an MRI.

Louis. . .

MRI as a Screening Tool?

Can an MRI examination be used as a screening tool when the patient has high PSA numbers and a negative biopsy? I have been reading the postings to this group for months now. I know the importance of an early detection. I also know that biopsies can miss. While MRI examinations are used after a positive biopsy, I don't read of any cases where a patient with consistent elevated PSA readings and negative biopsies then undergoes an MRI for the discovery of the cancer. How come? What am I missing?

[Guest guest]

MRI has poor resolution for small tumors, which are likely if a

biopsy

is negative. As others have pointed out, a " high " PSA is not

necessarily indicative of cancer. Other causes include an enlarged

prostate and inflammation such as prostatitis.

For you, how " high " was " high " ?

Perhaps the most experienced group in the U.S. for MRI applications

to

prostate cancer is at the Univ. Calif. San Francisco (UCSF). They use

a

combination of MRI and spectroscopy (MRSI) in both clinical and

research studies. A brief summary can be found at:

http://www.prostate-

cancer.org/education/staging/UCSF_CombinedMRI_MRSI.html

However, for routine scans even this group has poor resolution for

tumors smaller than 1 cc (cubic centimeter). The odds are that MRI,

even for such an experienced group, would not provide any additional

information than a good biopsy (12 or more cores).

For a small tumor, it is more likely that the less expensive color

Doppler Ultrasound imaging will provide more information than MRI.

It

also can detect serious prostatitis.

If you have had a biopsy, the information should have included an

estimate of your prostate size and the doctor should have discussed

the

implications of the size versus the PSA. If you have had mutiple

negative biopsies with " high " PSA, your urologist should have

discussed

potential non-cancerous reasons for elevated PSA and ways to further

investigate why the PSA is high.

The Best to You and Yours!

Jon

>

> Can an MRI examination be used as a screening tool when the patient

has high PSA

> numbers and a negative biopsy? I have been reading the postings to

this group for

> months now. I know the importance of an early detection. I also

know that biopsies can

> miss. While MRI examinations are used after a positive biopsy, I

don't read of any cases

> where a patient with consistent elevated PSA readings and negative

biopsies then

> undergoes an MRI for the discovery of the cancer. How come? What

am

I missing?

>