Gadolinium enhanced MRI improves diagnostic accur... - PMRGCAuk

PMRGCAuk

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Gadolinium enhanced MRI improves diagnostic accuracy in PMR!

8 Replies

"If recurrences can be predicted by gadolinium-enhanced MRI, rheumatologists can consider using anti-rheumatic drugs in the early stage for PMR patients." ~Stacey L. Adams

It's a big "IF," but still.... it's encouraging that they're looking for new ways to diagnose earlier!

healio.com/rheumatology/vas...

8 Replies
PMRpro profile image
PMRproAmbassador

Hmm - but it it must be balanced with the fact that a) gadolinium MRI scans are very expensive, in the US even 15 years ago you were looking at a co-pay for the patient of over $1,300 and b) that gadolinium has been found to be deposited in the brain and it isn't known what the long term effect of that is.

Some experts have suggested there be a new disease label "gadolinium deposition disease". Whether that is overreaction or not will require to be shown by extensive monitoring studies on patients who have undergone the procedure.

ncbi.nlm.nih.gov/pmc/articl...

in reply to PMRpro

Yes... of course. The last paragraph of the article actually says;

"However, gadolinium-enhanced MRI has some disadvantages: high costs, adverse effects of gadolinium, and unavailability in some clinics, and ultrasonography is easier to use than MRI . We need to validate the results in a larger cohort and optimize and standardize the gadolinium-enhanced MRI procedure for PMR to apply in clinical practice.”

I was just happy to see that "they" are looking at alternative diagnostic practices and PMR/GCA is not just being ignored.

PMRpro profile image
PMRproAmbassador in reply to

I replied to flesh that fairly standard disclaimer out a bit ...

in reply to PMRpro

Ahhhh. Thanks

Joaclp profile image
Joaclp in reply to

I would think that ultrasound was inexpensive enough to make it standard. They certainly use it frequently in the US for quite a few things.

PMRpro profile image
PMRproAmbassador in reply to Joaclp

It is the capital cost of buying the extra machine - it isn't a common piece of equipment in a rheumy department clinic - and the training of at least 2 people to do the scan so there is constant cover. Which very likely means employing at least one as a new post and it takes 6 months to do the training for most specialist scans - and the ongoing running costs of salary, disposables and maintenance.

Rimmy profile image
Rimmy

Thanks M always invaluable to see the references to research people post here on HU and similar platforms as it's hard for us to be 'on top' of it all. Sometimes of course it will be about something which appears as VERY relevant to most of us and sometimes (although obviously more rarely)it can be even 'immediately' useful. Anyway 'all' of this is grist to the mill and here I have noticed particular but less obvious subjects and aspects relating to PMR/GCA crop up on and off - and hope perhaps in the future this unique conglomeration of the 'personal' and 'professional' will be an invaluable source for researchers ... X

in reply to Rimmy

Thanks Rimmy, glad you found it interesting/useful. 👍🏻

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