MRI Choices for Prostate - Normal MRI or Endorectal?

Posted , 10 users are following.

I live overseas and have somewhat limited choices as to tests and the ability to make a complete diagnosis.

In the past, I have had a prostate infection, hematospermia, a slightly varying and high PSA (5+)and I have generally been diagnosed with an enlarged prostate and BPH.

I have had two TRUS exams. There didn't seem to be much change in the results; 3 years apart. An enlarged prostate and one noticeable node.

I am currently taking Cardura, but still having a somewhat difficult time with urine flow and strength.

My doctor, given the testing choices available here, has recommended an MRI.

However, they do not have the ability to do an Endorectal MRI - only the regular-type body MRI exam.

I am wondering if this type of MRI will provide any practical results.

I am assuming the Endorectal MRI would be more useful.

The regular MRI is not cost-prohibitive, but I am wondering if it will yield anything useful.

Thanks

Andrew

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14 Replies

  • Posted

    Andrew,

    I am NOT a Doctor, only a patient, so this information is worth exactly what you are paying for it. I believe the MRI body scan "with and without contrast dye", both, provides an excellent set of images/report for the areas involving the prostrate. If available, get the 3T MRI, also known as the MRI 3T

    YMMV

    Good Luck Brother,

    Chuck

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    • Posted

      MRI with endorectal coil is usually done with 1.5 Tesla machines, the best is 3T mpMRI , in most cases without any endorectail coil and provides the best results,

      endorectail coil may contribute to some image quality issues

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  • Posted

    Andrew:

    I just had a 3T multi-parametric MRI of the prostate this past Thursday. I'm not sure what a "regular" MRI is with regards to the prostate, but as I understand it, a multi-parametric MRI for the prostate is the current state of the art. So this type of MRI provides multiple parameters such as T2, ADC, DWI, etc.

    3T stands for 3 Tesla, which is the strength of the magnet. With 3T a pelvic coil can be used. With the weaker 1.5T multi-parameteric MRI, an endo-rectal coil is used.

    So you might talk with your doctor, but I believe the difference that you are interested in is if you are getting a multi-parametric MRI.

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  • Posted

    Hey, I too recommend a 3T MRI of the prostate, not the whole body, if you can get it. No coil is used and the images are crystal clear. Far better than 1.5T.

    That said, the KEY is not what MRI you have, but ensuring you have an expert radiologist specialising in prostate images.

    I live in Australia and was offered a 3T or 1.5T. I wanted the 3T but given I had brain surgery a few years ago, 1.5T was the safe choice. I found a place with a radiologist expert in prostate images and know that a 1.5T MRI with such a radiologist is a better diagnostic tool than a 3T reported on by a humdrum radiologist.

    Best wishes to you Sir.

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  • Posted

    Barney:

    If you don't mind me asking, why was the lower tesla MRI safer? I thought there was no danger from an MRI as long as there wasn't any metal inside the body?

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  • Posted

    Thank you for the replies.

    I just looked at the hospital website.

    They have a MRI 1.5 Tesla machine, so that will have to do if I decide to get one.

    Agreed, that the quality of the technician probably plays a big role in something like this.

    Andrew

    Alternatively, I have contacted a hospital in Thailand to see what services and equipment they have.

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  • Posted

    The Bangkok Hospital has a 3 Telsa. The price for an MRI is around $1,000 plus the time and expenses needed to travel there.

    If I do the 1.5 Telsa here in Cambodia, the price is less than $600, though there are other medical facilities that do it cheaper - but not at my regular hospital/urologist of choice.

    Of course, the quality of equipment and the technician may be what matters most and that can be problematic. I generally trust the hospitals in Thailand more.

    Andrew

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    • Posted

      Do you have any metal in your body? If so, then a 3T may not be safe.

      Do you know a very experienced radiologist to report on the images, irrespective of where you have the scan?

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    • Posted

      Not sure if this is appropriate, but I've heard that Dr. K in Houston allows prospective patients to upload MRI images which he will review. Perhaps Andrew could contact him and pay him a fee to review the images.

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    • Posted

      Sorry for the late reply. If the fellow you're speaking of is good then it's worthwhile to ask if he can read the images and report. Normally such folk will want a patient to visit (ie pay for a consult) but many who are located far from the patient would report for a fee without the need to visit. A report by a junior doctor or an all round radiologist is throwing money down the drain, IMHO.

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    • Posted

      Dr. K in Houston is considered to be, at least on this blog, the best doctor for FLA (focused laser ablation). He consistently gets very high marks on this blog. My understanding is that FLA of the prostate is conducted using MRI.

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    • Posted

      you may also consider Dr.Joe Busch, a radiologist in Chattanooga, TN, likely the most experienced prostate MRI reader anywhere in the world, he does reviews of patients images, I believe it's $250 for his review

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