The Comprehensive ASPS Scan Schedule & Discussion + Advice

[D.ap]

Olga

Olga-
In reading your response to Kathy and Tom on the detection of mets at 20 mm with the PET , it seems to me that onocoligists need to order a different set or a diffferent scan for the bone scan if the mets might not be showing up until they are 20 mm ?

Thanks in advance
Debbie

[D.ap]

Or am I wrong in assuming PET is for bone scans?

Debbie

[Olga]

PET is not the bone scan, it is a different type of scan. PET is used to check all over the body (combined full body PET/CT is also often done with the low resolution CT added to get more exact location and size). Bone scan is only done to check the bones.

[Josh]

Just wanted to update that in my previous post I had misunderstood how a CT with Contrast is performed. It is not actually 2 scans, but my onc had apparently ordered my CT scans with AND without contrast, so that is why I thought there were 2 scans--because my onc was ordering 2 scans. Just wanted to ensure that no one reads my comment and is misled, as it won't let me edit the comment

[Olga]

Josh - this is how the comprehensive CT with the contrast is done - first they do a CT without a contrast, then the contrast is given and a CT with contrast is done - they compare two results and get more info. In general, the dead tissue should look about equal on both scans and viable tissue should look different.

[Josh]

Josh - this is how the comprehensive CT with the contrast is done - first they do a CT without a contrast, then the contrast is given and a CT with contrast is done - they compare two results and get more info. In general, the dead tissue should look about equal on both scans and viable tissue should look different.

Olga:
This is what I had thought also, but my onc says that it is only done this way if he orders it with AND without contrast. Otherwise it is only a single scan with contrast. I will verify this with the tech at my next CT scan, though.

[Olga]

Probably not all the regular CT scans have to be that comprehensive and consist of 2 scans. The patient gets a pretty high radiation dose that way so prob. only some scans should be like that, between the regular ones.

[Ivan]

Dr. Littrup is able to tell based on only a scan with contrast whether something is getting blood flow or is not. He requested once to have a follow up done on a complicated case with first and then without, but most of the time he was able to tell anyway based on just with contrast.

[Amanda]

From what i was told the contrast shows as Ivan said with blood flow... I get them with out the contrast now it makes me sick. But, if there is a new spot they are going to use the contrast,

[D.ap]

Ivan and Olga

Don't know if heart MRI scan would be appropriate to be discussed in the discussion.
Maybe just linking to the section on heart, and as far as that goes liver and what ever else people have had to scan as a result of ASPS.
In reference to CT with contrast, I feel it is important to have blood work as Sree and yourselves have noted to check functions of kidney etc. The contrast is hard enough on a person with the radiation but a persons kidneys need to be able to filter it out after the procedure

Debbie

[Jorge]

The resolution of Brain MRI:
I discussed this with Ivan before. The resolution of brain MRI is usually not high enough to catch the tiny mets (mm diameter) if there is any, because the scan is done in 3 dimensions. We have 3 times of experiences that the positioning scan before Gama Knife found more mets that were missed in the 8mm resolution 3 dimension MRI with contrast.
The positioning scan before Gama Knife was done in 2mm resolution but only in 1 dimension, also with contrast. The Gama Knife doctor told me that 1 dimension scanning is enough; the regular 3-dimension scan can be used to see the skull structure etc, which is not applied to our case now. If there is a skull problem, we can ask for further check.
I think it's better to have a scan in a higher resolution to compare with last time or we can't tell which one is treated, which one is new. I discuss with the radiologist and they agree to use the positionning scan mode this time.

Ivan, I remember you said you will request your radiologst for a higher resolution of brain MRI next time, but I have a concern. What's the effective time of the contrast medium? Can it support the scan of over 30 minutes?

[Ivan]

Jorge, I'll let you know the details. I'll make sure to have a good chat with the technologist when I do my scan on Jan 31. It will be at the other hospital with the newer MRI machine. If they don't have enough information, I'll asks the neurosurgeon. I don't want to yap at him unless necessary, as he is very busy already.

[D.ap]

To all the ASPS patients and families
Pasted this from the 'heart metastasis ' section. I felt it important to know as it could be requested to be performed before and during trials , maybe? Or before or during systemic treatments ?

Olga writes after I asked about being able to detect heart tumors which as I understand are rare
Larger tumors at ?? Cm can be detected by an Echocardiogram however smaller tumors as follows:

Debbie - we had another patient with the heart metastasis found by the MUGA scan - (Multi Gated Acquisition Scan) is a nuclear medicine test designed to evaluate the function of the right and left ventricles of the heart, the patient is given a tracer in order to visualize the heart by this scan. She had this scan as a part of her pre-screening for eligibility for the clinical trial, to see if heart function is normal - that's when it was found. I am not sure if the ECG shows anything in case of the small heart met.

[Jorge]

Hello everyone,

How do you check your pelvic cavity, CT or MRI? I didn't see the pelvic CT/MRI in the schedule recomemded by Ivan. Is it necessary for men to check the pelvic?
I requested apelvic CT for George, but the radiologist said a clysis is required before the CT. So George didn't have it.

Any input/suggestion will be highly welcome.

Thanks,
Lynette

[D.ap]

Lynette
Found this article on CT v MRI of pelvic
I think that it is just as important for guys as girls to get one as far as ASPS goes .
We all have livers and kidneys and pancreas 's.
Debbie

What Can a Pelvis MRI Show That CT Can’t?



written by: AlyssaAst•edited by: Emma Lloyd•updated: 7/24/2009

Many medical conditions of the pelvis can be diagnosed using two imaging methods, a pelvic MRI and a CT scan of the pelvic
area. These imaging techniques are very similar but have differences in the images they can produce. What can a pelvic MRI show that CT can’t? Find out in this article.

There are many times, a pelvic MRI or a pelvic CT scan need to be used to diagnose medical conditions or abnormalities. These two diagnostic testing tools both produce images that can be used to diagnose medical conditions. Although the two tests are very similar, there are differences in the images they can produce. What can a pelvic MRI show that a CT can’t? There are a couple differences in the image quality and ability of each machine.

What is a Pelvic MRI?
Pelvic MRI’s are used to produce images of the lower abdomen and pelvic region. Pelvic MRI’s can show images of the reproductive organs. The MRI machine used for the pelvic examination uses a powerful magnetic field along with radio frequency pulses. These two things, along with a computer produce, very detailed images of the internal body. This diagnostic test can produce images of the soft tissues, organs, bone, and almost every other internal component in the body. MRI’s can produce better images of the body than other diagnostic tools, such as CT scans and x-rays. MRI's can be more difficult to conduct because it requires absolutely no movement of the person in the machine. Breathing can evan blur the images.

What is a Pelvic CT Scan?
A pelvic CT scan can allow doctors to properly diagnose medical conditions using a CT machine. This machine uses x-ray equipments and computers to produce images of the inside of the body. The machine produces cross-sectional images that can be used to diagnose medical conditions. Pelvic CT scans allow doctors to see bones, blood vessels, organs, and soft tissues inside the pelvic area. These images are clearer and more detailed than the ordinary x-ray. CT scans are not as sensitive to movement as MRI's, but too much movement can still blur the images.