Can MRI reliably detect mets?

[garyjp9]

I had a lumbar-sacral MRI done for orthopedic reasons. Would it have shown any detectable bone mets in the study area? Same question as to any suspicious lymph nodes? Thanks.

[Tall_Allen]

Only if they are big enough (>5 mm). It is used to localize big ones rather than find them.

[garyjp9 in reply to Tall_Allen]

Thank you, TA

[GP24]

If the reader did not have the objective to look for mets you cannot expect that he detected them reliably.

[garyjp9 in reply to GP24]

Thank you

[NecessarilySo]

If you get a copy and study it on your own it may be possible for you to see something missed by a radiologist, if you know precisely where to look.

[garyjp9 in reply to NecessarilySo]

thank you

[Skifanatic]

I was having pain in my left hip, went to my orthopedic doc in October 2022 and he first did an x-ray which didn’t reveal any possible source of the pain. He then decided to order two MRIs, one for my pelvis and one for my abdomen. The MRI on the abdomen revealed a 2.6 cm tumor in my L3, and two enlarged lymph nodes. See report below. I remain ever-grateful to him for being persistent and ordering these tests, which led to me getting a PSMA Pet scan which revealed widespread metastasis. Since then I’ve been through six treatments of docetaxel + Carboplatin, and just had my first of six Pluvicto treatments on Thursday.

MRI LUMBAR SPINE (NEURO) WITHOUT CONTRAST TECHNIQUE: Multi-sequence, multi-planar MRI of the lumbar spine was performed without intravenous contrast. COMPARISON: CT ABDOMEN/PELVIS (GI) WITH CONTRAST 2017-Jun-01 FINDINGS: Alignment and Vertebrae: Exaggerated lumbar lordosis. No compression fracture. Marrow: There is a 2.6 cm T1 hypointense, T2 mildly hyperintense lesion within the vertebral body of L3. No other lesions identified within the lumbar spine. Discs and Endplates: Normal intervertebral disc heights and multilevel disc desiccation. Conus: Terminates at the L2 level. No signal abnormality. Other Findings: There are numerous enlarged left paraortic lymph nodes, measuring up to 1.2 cm (series 7, image 7). These findings are new since prior study dated 8/21/2019. Findings by level: T12-L1: Normal. No spinal or foraminal stenosis. L1-L2: Normal. No spinal or foraminal stenosis. L2-L3: Mild bilateral facet arthropathy. No spinal or foraminal stenosis. L3-L4: Mild diffuse disc bulge. Mild bilateral facet arthropathy. No central spinal canal stenosis. Mild right neural foraminal stenosis. The left neural foramen is patent. L4-L5: Mild diffuse disc bulge. Moderate bilateral facet arthropathy and thickening of the ligamentum flavum. No spinal or foraminal stenosis. L5-S1: No significant disc bulge. Moderate bilateral facet arthropathy. No spinal or foraminal stenosis.

IMPRESSION:

1. Indeterminate lesion within the vertebral body of L3. In the setting of known prostate cancer, findings may represent a site of metastasis.

2. Numerous enlarged left paraortic lymph nodes, measuring up to 1.2 cm (series 7, image 7). These findings are new since prior study dated 8/21/2019. Findings are suspicious for metastatic involvement.

3. Multilevel degenerative changes of the lumbar spine. No high-grade spinal canal or neural foraminal stenosis.

[garyjp9]

Yes, thank goodness you had such a conscientious doctor

[j-o-h-n]

"I remain ever-grateful to him for being persistent and ordering these tests"

If you haven't done so yet.... buy him a good bottle of wine.....

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 05/28/2023 10:38 PM DST

[RMontana]

Will try to reply to this...from what I understand MRI is better for Prostate gland or bed PCa detection...for MET your best bet is PSMA PET...some different types, but PSMA PET is best. The tracer binds exclusively to PCa antigens (the cancer tumor cell surface membrane). Then the radioactive tracer 'annihilates' and emits photons (light)...this makes PSMA PET very 'specific' to PCa, meaning when it lights up its 95% + right at finding PCa (ribs excluded). Check this out if you dont have this considered;

healthunlocked.com/active-s...

healthunlocked.com/active-s...

[garyjp9]

Thanks very much. Good to hear from you.