2ND Opinion by Radiologist

[Jimbo47]

I recently had mpMRI and PSMA/PET scans that indicate I have cancer in the Seminal Vesicles and Lymph Nodes. I want to have the slides sent to a radiologist for a 2nd opinion. Can anyone recommend a good radiologist that can complete this task.

[Tall_Allen]

At UCLA, Jeremie Calais would be my top pick.

[Jimbo47 in reply to Tall_Allen]

Thanks TA. I'm trying to take the right steps with all of this. I've got the shock of realizing that the cancer has returned and responsibility of developing a process that will provide the best outcomes. Any help that you can provide would be much appreciated.

[Tall_Allen in reply to Jimbo47]

You can't go wrong with Amar Kishan.

[Retireddoc in reply to Tall_Allen]

You are confusing Radiation Oncology with Diagnostic Radiology. The Diagnostic Radiologists are the ones that actually interpret the Imaging (MRI, PET etc). A Radiation Oncologist would not issue a second opinion interpretation of these tests. They would look at them as part of their treatment planning but would defer actual interpretations to the Radiologist. I practiced Radiology at a major medical center and recently retired after 40 years.

[Tall_Allen in reply to Retireddoc]

Thanks, I know the difference. If you read his post, he was asking for extra help.

[Retireddoc in reply to Tall_Allen]

Ok. Fair enough.

[j-o-h-n in reply to Retireddoc]

40 years? Congratulations!!!

youtube.com/watch?v=qQzdAsj...(Not working as expected?)

Good Luck, Good Health and Good Humor.

j-o-h-n

[Still_in_shock]

Who did the study this time?

[Retireddoc]

Good morning! As a retired Radiologist, I wanted to respond to your question.

Many laypeople get Radiologist and a Radiation Oncologist confused. They do two entirely different jobs. Radiology in the beginning of the specialty combined the 2 fields. Around the early 1970s they became separate specialties, Diagnostic Radiology and Therapeutic Radiology.

The Therapeutic Radiologists are the Radiation Oncologists. Their job is to administer Radiation to treat cancer. Although they may look at PET and MRI scans in the course of their treatment, they are not the experts in these Imaging tests and are not the ones that interpret them and actually render a report.

That leads us to the Diagnostic Radiologists. Diagnostic Radiologists are the ones that read/interpret the various imaging tests most people are familiar with-PET, MRI, CT, plain films (like ankles and chest x-rays), bone scans ultrasound etc, etc.

Beginning in the 1980s an additional new specialty in medicine evolved, Interventional Radiology. Up until about a decade ago, Interventional Radiologists were also trained in Diagnostic Radiology and interpreted Imaging (PET, MRI, CT etc). They are now 2 different specialties. Interventional Radiologists were the physicians that developed angioplasty (to open arteries anywhere in the body including the heart), biopsies (we were the ones to first do prostate biopsies in the 1990s), treating various cancers with heat and cold by inserting probes into the tumor by CT or US guidance, stabilizing fractures of the spine by inserting cement (Kyphoplasty) and much, much more. I practiced Interventional Radiology but also interpreted Imaging (CT, MRI, PET etc) for 40 years.

This is a long winded explanation to tell you if you want a second opinion on a PET or MRI reading you want a Diagnostic Radiologist. At a Center of Excellence, Diagnostic Radiologist likely sub specialize in interpretation of PET, CT, MRI etc. so twi different Radiologist would read the studies (one for PET, a second for the MRI. You can look at the websites of major medical centers(under Diagnostic Radiology) and they will usually say if they offer outside second interpretations. Or call the Department of Radiology and ask for the PET and/or MRI Divisions and they can answer your questions.

I saw another poster offered a name of a Radiation Oncologist as a source. They do not primarily do or offer interpretations of PET or MRI. If you were seeking a second opinion for Radiation treatment of prostate cancer, as part or the process your Imaging studies would be reviewed by the Radiologist and the information given to the Radiation Oncologist.

Hope that helps.

[Researcher50 in reply to Retireddoc]

WoW! What great information for everybody! Never knew.

[dhccpa in reply to Retireddoc]

Which one does a bone biopsy (if any)?

[Retireddoc in reply to dhccpa]

Interventional Radiologists do bone biopsies at most institutions, especially if they are image guided (under CT or occasionally MRI) and targeting a lesion in the bone.

If it is just a bone marrow biopsy some Medical Oncologists do their own.

[dhccpa in reply to Retireddoc]

Thanks!

[Still_in_shock in reply to Retireddoc]

Didn't TA reconebd Jeremie Calais? Nuclear medicine physician specialized in cancer imaging and theranostics.

[Retireddoc in reply to Still_in_shock]

I believe he did, but most NM physicians do not interpret MRI at major medical centers. It depends on their trading. Most NM physicians are Radiologists who did a Fellowship in Nuclear Medicine (and do have training in MRI interpretation) but some NM physicians took a different track and are trained in some other specialty but then took a Fellowship in Nuclear Medicine and practice that exclusively. Nuclear Medicine physicians (regardless of training) are experts at interpretation of PET.

[Cali3]

One option is to have your MO or RO put in request for a second read. We had the MO request that for us.