Newbie Questions!

Shefian

What is mpMRI?

Edited by member 19 Aug 2020 at 18:13  | Reason: Clarification of source

This is not quite correct on two counts...

The contrast is injected part way through the scan (usually nearer the end). Tumors grow blood supply more haphazardly than the organ as a whole did during its development. This shows up by having a different flushing rate of the blood through the tumor versus the properly developed parts of the organ. The contrast is injected quickly to generate a slug that hits the prostate at once, and the MRI can then observe the rate at which is it flushed out of different parts of the prostate, and this forms one factor which is used to identify tumor areas from normal areas.

A contrast agent is not an essential parametric of multi-parametric scan, but it is a very valuable one. People with poor kidney function might not be given it, because of the extended time it takes for kidneys to remove it from your system. There are some other parametrics which can be used when contrast can't although probably with inferior results. Some people having contrast might be asked to stop taking some drugs which normally present a load to the kidneys for a few days beforehand, to help the kidneys get the Gadolinium out of their system faster.

Firstly, can I thank Andy and Chris for making us aware that the content of this news article contains a number of discrepancies.  The following is a response from out Policy Team.

A contrast agent is not an essential parametric of multi-parametric scan, but it is a very valuable one, what we consider to be the gold-standard of mpMRI. People with poor kidney function might not be given it, because of the extended time it takes for kidneys to remove it from your system. There are some other parametrics which can be used when contrast can't although probably with inferior results. Some people having contrast might be asked to stop taking some drugs which normally present a load to the kidneys for a few days beforehand, to help the kidneys get the Gadolinium out of their system faster.”

This gets into the distinction between biparametric and multiparametric MRI – technically the contrast injection is essential to make it an mpMRI as that is included in the definition of the term, but some argue it is not essential to get an idea of what’s going on in the prostate, i.e. that bpMRI is sufficient. Our view is that the current gold-standard evidence was acquired using mpMRI, and therefore the contrast step should be included unless clinically contraindicated.

The article  would of been written with simplification in mind at the time.  We will  amend this page to add 'during the scan' and not administered if clinically contraindicated, for example, when dealing with kidney problems. or words appropriate to convey these points.

In our health information (https://prostatecanceruk.org/prostate-information/prostate-tests/mri-scan), we say the following, which  is accurate on both of the points raised:

                                The radiographer might give you an injection of a dye during the scan. 

We would always advise that you refer to our Health Information publications and not news articles as these may ( as in this case) not accurately reflect clinical guidance.  Our Health Information goes through rigorous assurance before publication and is regularly reviewed to ensure it reflects current research and protocols.

Sue

Peer Support Manager

Edited by member 20 Aug 2020 at 09:19  | Reason: Not specified

A trick I used to use on sites which were intermittently problematic for random reasons was to copy your text to the clipboard before hitting the "post" button. Then if it goes wrong, you still have your missive and can repaste into a new reply window or save in a file to retry later.

The frustration when you lose a long message is awful, but I've not experienced it on here (Chrome on a Macbook).