MP vs bp mri and contrast toxicity

[Mufj]

Afternoon all

hope everyone is doing well or at least as well as expected this new year

I am currently on AS, profile show the details

In 4 years have really seen no chang, currently with Pennmedicine in phila

so far happy with whats being done but now want to make some changes and reviewing

Concerned about toxicity of contrast agent FDA has made recomendations that repeated use be avoided

I have read the contrast agent is only useful under certain circumstances and bpMRI can be equally effective

add to that I consider myself in very low risk with 4 biopsy and no pattern 4 found and the most pattern 3 is 5% in 1 core out of 12, on top of that have 3 mpMRI with no change and provides a good basis for comparison(T2 and diffusion weighted ),

would like to eliminate contrast agent on a regular basis but use if really neccessary and would like to spread biopsy to every other year and as I get older to every 3 year.

Another sidebar is I have been Dx with dupytrens disease(thiickening of tissue in hand leading to contraction of fingers) it is a mild case but symptom seem similar to what can happen with gadolinium toxicity. I have found no evidence that the gadolinium is the cause(I am at risk cause of genetics) but just want to be cautious so this is a balance of risk

My doc is discouraging this cause of increased risk but seems unaware of FDA recomendations. He is older(70's )and though experienced may not be ups to speed and penn being a big organization may be locked into a certain procedure

Evaulating whether switching to another AS program would be a good idea so any recomedations on programs

thanks all for any input, opinion and experience

[Tall_Allen]

The data on bpMRI look good, but there haven't been the prospective studies to prove it. Of course, it all depends on having a good radiologist. You may want to work with Dan Margolis at Weill Cornell or Mohummad Siddiqui at JH

[cesces]

Mufj

I have generally been concerned about the general disconcern, and cowboy attitude of the healthcare community regarding contrast agents.

When I ask questions, I never seem to get well informed answers. It seems they are only parroting back what the salesperson told them, with no true understanding, not desire to understand.

It's sort of hard to follow you with all the cryptic sentences and heavy abbreviation.

Can you articulate exactly what contrast agents you are dealing with for what kind of scans, for what specific ends, how frequently.

Can you explain why exactly they are using MRI.

MRI scans aren't commonly used for prostate cancer. What is different about your case that it is being used?