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Diffusion MRI?

Posted , 8 users are following.

caz11527
caz11527

Hi all,

I'm hoping some of you will be able to explain what diffusion MRI is. I'll try not to repeat myself too much, I have a couple of other posts on this forum regarding my partner. Anyway, he is due to have his 3T MRI scan next Wednesday. However, we don't think the diffusion is being carried out. We did ask but the receptionist wasn't sure. What I really want to know is if it is just a straightforward 3T scan will this give good enough clarity? We don't really know what diffusion is apart from it being something to do with cell density. Is it something that is likely to be routinely carried out during a 3T? We want to have the best tests available before proceeding to biopsy. We know they won't be using a contrast dye as they said it isn't necessary for prostate imaging. I'm hoping someone can help me with this. Thank you.

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  • caz11527
    caz11527

    Posted

    I don't know why they are not using contrast. They seem to think that it wouln't be needed as the 3T gives a very clear image of prostate including the edges, without dye. He would be happier if they did use it. He is speaking to GP this morning and asking for a kidney function blood test as this seems to be a requirement before they inject dye in other clinics. Our centre is in a large teaching hospital and is classed as a centre of excellence so based on that we just trusted that they would do all that was necessary in order to give the best scan possible. We will ask on arrival for the contrast and see what the response is then.

    • harveybronx
      harveybronx caz11527

      Posted

      I'm about to rack out now (navy talk), so I'm doing this from memory and I might be wrong.  However, I thought the sole purpose of the dye was to distinguish the rate of its diffusion into PCa tumor compared to normal cells, which is very different, as well as the rate of washout.  That's the DCE parameter, which is Dynamic Contrast Enhanced.   And this is one of the parameters used in the mpMRI to distinguish significant cancer from insignificant cancer or benign cells, and not to miss anything.  According to the PI-RAD document, "DCE should be included in all prostate mpMRI exams so as not to miss some small significant cancers."  

      I don't believe it has anything to do with getting a clear image of the prostate or its edges.  I still don't understand.  Are they doing PIRADS mpMRI or not?  That article to which I referred spells out exactly what that is and what each parameter is.  Without use of the gadolinium (sp?) contrast material, i don't think it can be called modern mpMRI.  Why all this guessing?

      Harvey

    • derek76
      derek76 caz11527

      Posted

      In the 80's I had a kidney X-Ray with contrast dye and had a reaction to it. When I needed another about six years ago at a BUPA hospital I warned them in advance about it. They said it is a very different dye we use now from at that time and it should be all right but they had a doctor there as it was done.  

    • geoff90305
      geoff90305 derek76

      Posted

      Same Derek, I had a very bad experience when I was young having a scan. I thought I was boiling until a doctor raced in and injected me with antihistamine. The new contrast had no effect on me whatsoever.

      Geoff

    • geoff90305
      geoff90305 derek76

      Posted

      Yes, I saw that the other day. Damn...because I am on heart meds, I can not take cold/flu tablets or asprin, as they spike my blood pressure. Antihistamines did the cold relief job well, but triggered another issue I have with a urethra stricture....

      Some times I feel like I am on lifes pinball machine for medicines

      Geoff

  • j12080
    j12080 caz11527

    Posted

    CAZ all three of my 3T MRIs I have had in the last 15 months have been with pelvic coils and all have claimed the DCE and DWI contrast and imaging. All were at done at different location.  

    The last one was last month for the Focal Laser Ablation procedure I had on the 19th that I am now 24 days post op from. It was a wonderful procedure in every way and the results are now also fully wonderful with 100% approval as of two nights ago after successful sex. MY BPH symptoms are all but completely gone. Bladder retention removed completely now. Low grade suspected PCa area of the prostate also removed at the same time. I though this would be good but had no idea it would work this well. I understand that normal protocal for 3TMRI in prostate case use DWI. I used an Interventional Radiologist as Urologist no nothing about this procedure and push away from it. But it truly is wonderful. Used primarily for low to medium graded PCa but found it also apply very well to BPH. I felt I got two birds with one stone.

  • DrKaramanian
    DrKaramanian caz11527

    Posted

    Dear Caz,

    Disclaimer:  The following is general medical information and does not establish a physician patient relationship.

    Diffusion/ADC is one of three sequences/partsof a multiparametric MRI.  T2 primarily looks at anatomy, diffusion/ADC measures the ability of water molecules to freely bounce around, and dynamic contrast enhancement looks at blood flow.  

    Fundamentally, cancer occurs when cells replicate or reproduce too much.  When this happens in the prostate, cells get packed in too tightly.  This causes water molecules to get squished and restricts the ability of the water molecules to bounce around.  This results in "restricted diffusion."

    I've attached a picture from the ADC map on a patient I treated with focal laser ablation.  You'll see a small dark circle where his cancer was on his pre-procedure MRI.  This circle of restricted diffusion is where his cancer was.

    Best regards,

    Ara Karamanian, MD

    • caz11527
      caz11527 DrKaramanian

      Posted

      Good evening,

      Thank you for explaining this to me. I now understand how it works. He did have diffusion weighting as part of his 3T MRI and we get the results in a few hours.

      Thank you again, much appreciated.

      Caz

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