I had MRI at initial diagnosis, then after 3 lots of carbo/taxol to check response before surgery and then again after treatment of final 3 lots of chemo. The latest scan (last month) showed possible residual disease or scar tissue and so i am having a follow up scan in October to check. I did ask my oncologist why they use MRI and not CT scans but he wasn't very forthcoming (not my best friend!) just saying 'well if others had access to MRI they would use it' (??!). One of my chemo nurses said it is a better tool for disease in the abdomen but most of you stage 3+ ladies on here will have had that also and yet as far as i can see through posts on here most people have CT scans.
Any info/opionions would be welcome.
MB x
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mummybear59
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Angie has only ever had CT scans. I often wondered why some had MRI; it is a good question pose. From what I can gather, if an MRI is used first, then it is generally repeated to follow up because it gives a like for like comparison. I have no idea whether that is true or which method is most accurate/useful. I will be interested to read the answers to your question. I hope your follow up scan shows nothing to be overly concerned about.
Thankyou Andy. Wow that was quick. I had just sat down with a cuppa and chocolate (dark not milk, so its good for me!) in the camper van for a few pensive moments with a lit candle for Linda and wondered if anyone had posted anything in reply but didnt expect an answers so soon. I think you are right about the comparing like for like with the scans and that makes complete sense but it still doesnt explain why MRI was the chosen option in the first place. I think any scans are only as good as the radiologist analysing the results though!!!!
x
The following link may explain, my guess its cheaper to have ct scan xx
Thanks for the link. Maybe CT scans are cheaper, i dont know, but i somehow doubt my local health authority would opt for the more expensive option if others such as the Christie and Marsden opt for CT scans?. Its confusing for me because the link says 'for any pelvis or abdomen scan CT wins over MRI' which contradicts what my chemo nurse said?
I had an MRI scan before surgery, then have had CT scans since. CT scan 6 weeks after finishing chemotherapy suggested that the little marks left on the lymph nodes was scar tissue. Nobody suggested a follow-up scan to compare. They just used CA125 as a marker for a year until that started to rise and once it rose over 30 they did a CT scan, and another 5 months later.
Paul may well have put his finger on it. Are CTs less costly? From what I've observed and have heard over the last 28 months cost does seem to influence all sorts of things in our health care and oncologists don't necessarily feel comfortable with our asking too many questions that probe this. I'm pretty sure my former oncologist side-stepped questions where I rather feel an honest answer would have been, 'Your Health Board won't fund it'.
Hope this helps to shed light. We do, as patients and supporters, need to get to the bottom of this cloak of secrecy. I'm glad you've raised the question. xxx Annie
I do think cost has a lot to do with treatment options in the NHS but i still think we are very lucky to have it!! I do think that equality of treatment within the NHS is a bit wobbly though (wish i could do i jelly smiley!). But i doubt my local authority would have opted for a more expensive treatment unless it was clearly a better option? I dont think its to do with cost. But. As my oncologist seems to like to explain as little as possible i thought i might get some informed answers on here?!!
I normally have MRI for abdomen and CT for chest. I have been advised that MRI shows abdomen better and CT shows chest better. CT has radiation as opposed to MRI? I think it very much depends on local consultants/practices. When I had bowel blockage, the surgeon wanted CT done. Lakshmy x
That's really interesting. Good to know someone who has had both MRI and CT after initial diagnosis. I do know of others who had MRI at diagnosis but then after that CT scans. As far as i know MRI is used in all OC cases in our local authority. Anyway as long as the scan in October is clear i wont care which kind it is!! Unless my foot was scanned but that would just be daft!
Yes your reply does help, thankyou, i just wanted to make sure i wasnt the only one getting MRI scans!! I think i will go with the 'my scan was so precise it showed possible disease when it wasnt really there' thought at the mo!! x
I only had MRI scans...when I asked why not CT scans? I was told that they work better on the abdominal soft tissue, and are much safer than CT scans...hope this puts your mind at ease.
For purposes of tumor detection and identification, MRI is generally superior. However, CT usually is more widely available, faster, much less expensive, and may be less likely to require the person to be sedated or anesthetized.
The above is a quote from a science mag, I'm not sure it provides clarity but does relate to cost
I have only ever had ct scans, in fact, as our local hospital has more than one "magic donut" they always use the same one, as this gives a constant whatever to compare with. My hospital has also done a scan and drain at the same time, which means less trips into the hospital for me. I don't think cost is the issue so much as personal preference for the oncologist.....lets face it, we all know the opinions of CA125 tests, so why not the ct against MRI question?
Yes i think you have hit the nail on the head there Chris, i think it probably depends on the oncologist. The good thing with CA125's though is we can always make our own choice and go through our GPs if our oncologist isn't keen on doing them regularly.
I have had mostly ct scans, however if there has been any doubt it has been backed up with an MRI, personally I would rather have MRIs as I understand from what I have read and backed up by other comments here, that they are more effective in the abdomen, esp. for PPC which I have. Also no radiation, but they are more expensive and I believe some people find it claustrophobic, I luckily do not. I also agree that scans are only as good as the interpretation, most of my ct scan reports leave me less than confident.
Thankyou Nandi. I guess i am actually quite lucky to be given MRI scans though? At least you say i there is doubt it is offered as a back up? I am sorry you are less than confident about the interpretation of your scans, i do understand what you mean though. I have have had two different radiologists and i wish i could opt for the one i really trust! The one who did my first and second scan actually stopped me before i was leaving after my second scan (to see of things had improved enough after 3 rounds of chemo to operate) and said she wanted a quick word. She said she wanted to let me know that (although she obviously hadn't examined the slides fully and that would take time) that she could remember the last scan and the good news was that i had had a very good response to the chemotherapy and the tumours that were there before were much diminished. I was thrilled to bits! I had my appointment with my oncologist a few days later and he was very understated and wouldnt go into detail and just said well 'its operable now'. If the radiologist hadnt taken time out to speak to me (which i think is probably very unusual) i certainly wouldnt have felt so positive about the results! My most recent scan was performed by a different radiologist and although i wasn't expecting any instant feedback the report was a bit vague. Also it was a different scanning machine and when i asked why he said its because we dont need to see as much this time. Hmm. We do put our complete trust in these people don't we?
I would ask for copies of each scan, they are freely available if asked and allows you to analyse them in the comfort of your home. You can google any medical terms to understand the content. Xx Paul
Well i doubt very much my oncologist would agree to that! I think he only wants me to know what HE wants me to know. I asked him for a copy of my histology report and he said . . . . i cant remember the wording exactly but it went something like . . . . 'no i don't want to give you that because it is very technical language and you will end up on the internet and upset yourself about things you don't understand'!!!! I don't know if he thinks i'm stupid but to be fair i do end up talking nonsense as soon as i get in that room!
When you say you get copies of Sandra's scans do you mean the scan report? I suppose i could ask my GP?
Yep, the scan report. It can have a negative effect if when reading it sounds worse than the explanation by the onc. The onc tends to generalise things but when I read sandra,s last one it was,nt good reading so I got the oncologist to ring me to clarify a couple of items. It was,nt good news but at least I know where we stand.
You would,nt get the scan images themselves because it needs a trained eye to understand them. Xx
Wow your oncologist does sound a bit patronising Mummybear but I kind of get where he or she is coming from. Sometimes there's devil in the detail. If my scan does show this or that thing that is going in the wrong direction but doesn't need urgent intervention it can be better for some of us not to know. I'm happy to be left in ignorance and not worry about the detail because I feel well and I continue to be very active. My oncologist is concerned to preserve my quality of life and if I were aware of every little detail it might worry me and make me unhappy. I do believe that my oncologist rather than I will know when it's best to take action with regard to scans but then I think I'm lucky on that score. Perhaps not every patient has that trust in their oncologist.
I think having trust in our medical team is one of the most important things. I have a wonderful GP and some fantastic knowledgeable chemo nurses (who all seem to understand what i need to know!) and i am feeling really well, so i suppose for now i can put aside my oncologists lack of empathy as long as he is making the right decisions! My trust in him took a bit of a tumble though when i went for my last appointment and he quite clearly had not looked at my notes/file beforehand as he didn't even know i had had my scan! The jury is out. I will see how things are in October!
I live in New Zealand and over 3 years have only ever had ct scans except for my initial ultrasound. Definitely cheaper. Not that I pay anything but they are.
I get CT scans but I have had 2 MRI's both related to my back pain. The first part way through my second lot of chemo, which was not working, was to check that there had not been metastasis into the spine and the second was ordered last summer, by the pain clinic, to assess the extent of the spinal problems causing sciatica. I have a copy of that one that shows the saggy ligaments and bulging discs that are causing the trapping of nerve roots. CT scans do not show as much and my last one only revealed two small nodules which are not sufficient to account for my symptoms. Both my gynae & my oncologist think that I may have scattered "seeds" too small (<1mm) to show up scattered around the abdomen. I will probably start my 3rd lot of chemo in September, probably weekly taxol as I am now seriously allergic to carboplatin and cisplatin did not work last time.
I do not know if this helps but MRI's are, I think, more expensive (they take much longer) and for most of us CT scans give a good enough picture of what is happening to tumours. If I were you I would be grateful that you have access to the MRI despite the fact that it is like spending 1/2 an hour inside a pneumatic drill. They asked me if I had enjoyed the music and my response was "what music?" LOL!
I am actually beginning to be rather grateful for my MRI scans! To combat the noisy scan i create my own music by singing Disney songs in my head throughout! Sad i know! I also have to stop myself dancing!!! Anyway who knows maybe my recent 'spots around the liver' would not have showed up on a ct scan and i wouldn't have been offered a follow up scan in 3 months? But then again maybe ct scans give a clearer picture of disease in areas other than the abdomen? I think my wariness is just to do with the security of having the same treatment as other people if you understand what i mean?
Hopefully you will enjoy a problem free August before starting weekly Taxol in September. I have said this before but you are one inspirational lady and you have been through so much i am sure you will get through this too!
Love MB.x
I would imagine the running costs for CT are less plus the throughput of patients being much greater. Had we all had MRI then the backlog of appts would be horrendous due to the time it takes to complete. Then there are PET scans which use a radio active dye but these are used to understand if certain organs are performing as they should. Xx
Or maybe our health authority doesn't possess a CT scanner??!!! My oncologist did say something about if the next scan doesn't give enough clarity he will use a 'special' scan, which may have meant a PET scan but by this time i didn't have the energy to ask him what that was!
Its possible your hospital has a first generation 32 slice ct scanner. More modern ones are 64 slice or better, perhaps he thinks his mri will give better resolution that his ct if its old. Xx
Dear MB,
I have waited until now to respond, (as I haven't anything useful to add) I have never had an MRI only a CT scan, and I have wondered the same as you only the other way around, your post an interesting question, that has generated interesting comments, I can empathise with you, my oncologist is very similar to yours (they could be clones).
I also think that your radiologist was great, it is a pity that they vary in personality and helpfulness, but I do know what you mean, I had a picc line fitted on Friday, then had to have an X-ray to see if it was correctly placed, the radiographer gave nothing away so much so that I was convinced it was in wrong, but everything was ok.
I know you have commented before about your oncologist and i have thought a few times he sounds just like mine! Its really hard isn't it? I just keep telling myself that as long as he is doing his medical job well i can just about cope with his lack of empathy and presume this is the way you see it too? Have you ever thought about a second opinion? My friend said that to me after my last (tearful) visit to my oncologist. But to be honest although he is not 'Mr bedside manner' at this particular time i don't think medically anything different would have been done by another onc so i will save my 2nd opinion for when it is really needed.
And yes my radiologist was really kind and thoughtful, it's a shame they are not usually like that!
Lots and lots of luck with the chemo this time round.
I am constantly being told by others to get a second opinion, but like you I feel his people skills has no bearing on his knowledge or medical skills and I am still here five years on, I know a few people who wouldn't go to him anymore, they are no longer with us (now they might not have survived anyway) but I have a mental block on this now..( I will stick with it as long as I can )
Hee hee sounds scary Anne!! I agree completely with you though. The only thing is, at the moment, i am not totally convinced of my oncologist's expertise regardless of the fact i am not keen on his personality! Certainly up to now my medical treatment wouldn't have been any different elsewhere so that is fine. But his casual attitude at my last appointment (he obviously hadn't looked at my file before i entered the room as he didn't know i had had a scan!) has me on 'play it by ear'. If i feel after my next appointment he is not on the ball i will think about a second opinion. I would NOT however do this based on his unique bedside manner!
I had ct at diagnosis initially they did say would have ct and MRI but then decided just ct was needed. I was then refused any scan at end of first line treatment. At reoccurance I had ct. at end of second line I asked about why do ct and not MRI and was told ct is better for abdomen and MRI used more for cancer in organs as it gives slices picture so can see through the organ. I can confirm when I first diagnosed had ct privately and was £500 MRI was £750 so definitely more expensive
Thanks Sharon. There does seem to be a difference of opinion which method is best for Ovarian cancer but i guess we can only go on what our onc recommends. My GP says that any one scan can be interpreted in many different ways anyway!
Reading some of your replies reinforces how lucky I am to have my onc doc. She is always available to answer my questions and sometimes they can be panic ones. She will always ring me and if she can't get hold of me she rings after hours or my work or emails me. Never holds back with things I want to know, both good and bad. Gives me copies of my scans and blood results after explaining them to me etc and is FUN! On the other hand, my outpatient onc doc looks after the business side of things with regard to what treatment I am to have. I like and trust him as well but he is a little more serious. All I ask from them is honesty as its me they are talking about and I do like to know everything.
Hi. I understand exactly what you mean but i suppose not everybody wants to know everything. Because of this, unless told otherwise, i think most oncologists err on the side of caution and only give the information THEY think is important! I am like you however but my oncologist doesn't seem to have adapted his plan to suit me! My GP on the other hand just 'gets me' and will answer any questions i have and i trust her completely. Maybe as far as my onc is concerned i need to get a bit more forceful but, although it shouldnt make a difference to my treatment, i dont want to get on the wrong side of him! How rediculous is that?!
I ,too, like to know everything and think my oncologist is very straight and honest with me - therefore I trust him.
Sometimes you do have to be a little forceful as perhaps they don't realise how they are making you feel and sometimes they don't want to upset you,give false hope etc.
I think it can be difficult for both the oncologist and the patient sometimes and takes a while to understand each other.I do think most of them are used to a lot of different reactions from people and understand that people get angry and upset when faced with difficult scenarios.
I doubt any oncologist worth having would hold it against anyone.
Yes i agree it must be difficult to know how different people will reaction and to be fair i have only seen him 4 or 5 times. But if we actually ASK for information they should give us it don't you think? I just want to feel that complete trust that i have with my GP.
Hopefully things will get better and particularly if i say what i want to say when i am actually at my appointment instead of being pathetic!!
Yes I agree you should be given all the information you ask for.I am always very nervous at my appointments and often forget to ask things or feel my questions are silly.
I do think if I felt I wasn't getting the full facts I would consider changing oncologist .You need all the information to try to see the bigger picture and make informed decisions.
My gp apologised when I was diagnosed but I told her she couldn't have known and did all the right things over a two week start to finish. Stomach starting to bloat off to doc ultrasound ordered results back to her same day bloods done by her then hosp next day then diagnosis next day. My local onc doc knows more about the disease so that's why I ask her.
My GP acted very quickly too once i started to bloat. I had gone the previous week with what was thought to be a urine infection and then a reaction to the antibiotics but when i went back and showed her my stomach she immediately did a CA125, and organised an emergency scan and gynae appointment which took less than a week.
Personally, I tend to have CT scans on a regular basis and have only had 2 MRI scans. At 1st Recurrence and last year, both times was when surgery was being considered. My general understanding had always been that MRI was better for imaging soft tissue.
This website appears to explain it very cleary, in a tabular format.
from personal experience my daughter has MRI scans alternated with ultrasounds on her abdomen every 2 months and the only time she has had a CT scan was for her lungs. We did ask why not an MRI for her lungs and were told CT scans work for the chest and MRI for abdomen. The skill is with the interpretation by the radiologist and in the UK the protocol is for each scan to be looked at by two different people. With my daughter the first report came back clear and then 2 weeks later we got a call to say on the second report they had found a tumour. It seems like a good system and thank goodness the second radiologist spotted the tumour which was large but deep down in her pelvis in the pouch of douglas.
Thank you Julia. I didn't realise 2 people looked at the scans as standard. That is good to know. You will have realised how much we all help each other on here and although I am really sorry for the reason you have joined us i am also glad you have found us.
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i thought i might get some informed answers on here?!!
Still no CT scan results
New information CT scan
Timing for a CT scan?
CT scan spread but CA125 down?
