PET results vs MRI

[alephnull]

I had an Axumin PET scan a couple weeks ago(it showed mets on spine). Followed by an MRI, it didn't show any mets. A person on a facebook PCa group says, to believe the PET scan, but my Onco says the PET scan can have false positives and that the MRI basically proved it.

What say all of you?

[Tall_Allen]

You had a PET scan and a CT scan. Axumin picks up metastases, and the CT gives more precise info on where they are. An MRI doesn't prove anything. In fact, Axumin can show mets well before they are large enough to become visible on an MRI or CT, which is why it is used. A biopsy can prove they are bone mets, or if they get smaller on hormone therapy or chemo.

[jdm3 in reply to Tall_Allen]

Though if they don’t appear to get smaller, it does not mean that they are not resolved. It just means that the scan is showing scar tissue that cannot be differentiated from a malignant lesion.

[dac500]

In October 2018, I had a 3T MRI, which didn't show any metastatic cancer. Then PET scan detected metastatic prostate cancer in many pelvic and abdominal lymph nodes, which was verified by biopsy of one of the lymph nodes.

[EdBar]

Back in February I had an Axumin PET scan to rule out any non-PSA mets. My PSA has been undetectable for nearly 5 years however I’ve been using Xtandi for about 4 years and was experiencing some lower back pain. My local medonc (who is excellent and very knowledgeable) has had patients on long term ADT that had low PSA but an Axumin scan showed mets.

The Axumin scan showed uptake in an area of my spine that required further testing, this was stated in the report prepared by the radiologist. It would have been very difficult if not impossible to biopsy this area, so I had an MRI. It showed further deterioration in my lumbar spine but no active disease. The uptake was likely due to inflammation which can happen with an Axumin scan.

My scan and MRI results were reviewed by both my local medonc as well as Dr. Sartor at Tulane and both agreed with results. Dr. Sartor was also in agreement with following up using an MRI.

Ed

[Break60 in reply to EdBar]

MRI is SOP for spine orthopedic issues but not for spine cancer.

[EdBar in reply to Break60]

Well if Sartor and my local Medonc are good with it so am I.

[Fanger1 in reply to EdBar]

Hello Ed,

I am curious what your PSA was at the time of your Axumin scan? Did you get insurance to help cover costs despite the low PSA?

[EdBar in reply to Fanger1]

My PSA was undetectable, Medonc was checking for low PSA cancer since I’ve been on Xtandi for several years. I’m on Medicare.

Ed