• I had a Petscan, CT Scan and now an MRI. I am almost 3 yrs in remission but having back pain. Will the MRI show more detail?

    Asked by berly462005 on Tuesday, January 8, 2013

    I had a Petscan, CT Scan and now an MRI. I am almost 3 yrs in remission but having back pain. Will the MRI show more detail?

    The Petscan was fine, CT Scan showed some activity in the Thorasic Spine so my Dr decided to do the MRI. The MRI was intensive with uppper and lower back with and without contrast. Anyone else had all 3 tests to determine what if anything is going on?

    6 Answers from the Community

    6 answers
    • nancyjac's Avatar
      nancyjac

      The difference between the scans is not level of detail, but rather function. I believe you have confused your PET and CT results. A CT is a still photo of internal structures and cannot show activity of any kind. A PET highlights metabolic activity (increased metatbolic activity indicates an infection or inflammation). An MRI uses a magnet that is rotated to take multiple images of the same area from different angles to produce a 3D composite that shows the imaged area from a 360 viewpoint. This in turn provides date that allows estimating the mass and circumference, rather than just length and width.

      I have had all 3, with multiple CTs and MRIs. The purpose isn't just to find out what is going on, but how and to what extent it is going on.

      about 4 years ago
    • carm's Avatar
      carm

      Hello,
      I am an oncology nurse and maybe I can help clarify these tests. Often, many people get these three diagnostic tools while in treatment and there are many who ask the same question that you have posted. Before I explain them, let me take a moment to commend you on your question. Seeking these answers will empower you on your journey. It is questions like these that earn you that place among your team as a major contributor to your plan of care. Now for the tests in a nutshell:
      CT scans or Computed Tomography scan is that procedure during which contrast medium (dye) is introduced into the blood stream and a cross-sectional computer scan of the body's interior cavity is performed.
      MRI or Magnetic Resonance Imaging is a procedure where magnetic fields are used to produce an image of the body's interior using a dye composed of a heavy metal on the periodic table called gadolinium. There are subsets to this test like fMRI or a Functional MRI where during the test, you are asked questions ir asked to perform minor tasks during the MRI so that they can see the areas of the brain that are responsible for certain thought processes and physical actions. There is also an MRS which is a Magnetic Resonance Spectroscopy which is like an MRI or fMRI but this test looks at the chemical composition of the brain. It is used to detect dead cells in the brain after radiation.
      PET scans or Positron Emission Tomography is a scan where a small amount of radioactive material (fleurodioxiglucose or FDG) is injected into the patients' body, then absorbed by the tissue or organ being studied (cancer absorb it faster because of their rapid reproduction) and produces an image from the scan. With this test, the amount of absorption by a lesion is measured and that measurement is called Standardized Uptake Value or SUV. This measurement is from 1 to 15 and anything over a 2.5 is considered a malignancy.

      Because your doctor is now doing an MRI, he has probably ruled out any malignancy and getting a magnetic image is always more precise than the image from a CT scan. Whith the MRI, he is now no longer ruling out a possibility but ruling in a possible diagnosis. The images from a CT, although defined, can be vague. You can see by the shading that something is amiss, but you cannot get that kind of detailed image that comes with an MRI. I hope this helps clear it up. My best to you, Carm.

      about 4 years ago
    • nancyjac's Avatar
      nancyjac

      Doing an MRI does not mean the probability of a malignancy has been ruled out. I had 2 MRIs (one before and one after chemo). The first was as a diagnostic tool and the second was to determine the reduction of the cancer from chemo and to provide location information for the surgeon.,

      about 4 years ago
    • berly462005's Avatar
      berly462005

      Thanks ya'll for the explanations. Now I will just wait for him to call!!!! Carm-so I was a little confused about the last paragraph. The way I read it is there is probably no malignancy but just trying to see what is going on with my back?

      about 4 years ago
    • nancyjac's Avatar
      nancyjac

      None of those scans can determine if a mass is malignant. To do that requires a biopsy so that tissue from the mass can be examined at a cellular level.

      about 4 years ago
    • carm's Avatar
      carm

      berly, To clarify that last paragraph, according to what I read on your post, your PET scan was fine. A PET is used to find malignancies in oncology, and if yours was fine then perhaps your doc has ruled out a malignancy and is looking at an MRI result to find out what is responsible for activity in the thoracic spine. Radiologists do the wet reads and then interpret that wet read on a hard copy report. A doc goes by the recommendation of the radiologist. If the radiologist recommends a follow up scan like a PET, MRI or CT, usually docs follow that advice and schedule them. If it is recommended, it is because the radiologist could not explain the activity on prior scans so far. If the activity was due to a rapidly dividing cell, it would have lit up on the PET. PETS are used for oncology, cardiovascular studies, neuro, and brain activity. It is also used in research. It measures a cellular change or cellular activity, and depending on what type of patient they have before, them will also dictate the type of isotope used. In oncology it is the FDG and as an oncology nurse, I can tell you from experience that it is used to find a genotype that you would expect to see in an oncogene. I don't know what they might think it to be only that when I say they are trying to rule in, I am suggesting that they are trying to find out possibilities. Did not mean to confuse you, Carm.

      about 4 years ago

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