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MRI in 2021 - nano MRI advantages?

User
Posted 26 Jul 2021 at 06:58

Some new information as of June 2021.

https://www.youtube.com/watch?v=IoOecPYm0TM

NanoMRI combined with PSMA/PET can yield even better screening results.

Anyone aware of facilities un US and Europe that do this?

The one in presentation is in Netherlands.

Seems to be a better way of detecting mets, but from what I spoke with doctors - few are aware of this method.

Do forum members know anything more of it?

Thinking if this will yield a benefit in early diagnostic of potential mets for 59yr, 4+3=7, PSA7.8, T2C.

________________________

59M, Gleason 4+3, PSA7.8, T2C.

DaVinci Surgery or HDR Brachytherapy+EBRT or Cyberknife(SBRT)?

User
Posted 27 Jul 2021 at 01:37

I found the video quite interesting, but it is certainly not easy to follow. To tell the truth I prefer videos of cats doing silly things.

I requested copies of my own MRI scans. I could just about make out the anatomy but could not do any real interpretation of them. In this video Dr Jalf does a lot of interpretation of images taken with different techniques. Amazing that he can spot slight differences in brightness and conclude a lymph node is cancerous.

The later part of the  video showing hifu(?) being guided by MRI showing the whole prostate being destroyed in a very controlled manner was great.

As Barry said in one of your earlier threads most people on this site are uk based and treated on the NHS I don't think many of us will be able to better the research you have already done in this area.

On one of your previous threads you listed your treatment choices. Assuming you go for one of these excellent scans. How will it affect your treatment choice?

In the video he says he can now detect cancerous nodes down to 2mm, but presumably you will be worried about the 1mm cancers which he can't detect. 

If no micromets are discovered, will you book a scan somewhere else in the hope that someone else has a bigger and better scanner and they might find some?

If micromets are discovered, will you abandon any direct treatment of the prostate and just go on HT for the rest of your life?

Dave

User
Posted 27 Jul 2021 at 08:42
NanoMRI has been around for years - Swiss research project ran from 2012 onwards I think, and it is available in Israel?

It is quite irritating that you keep starting new threads rather than just adding to your previous one. I am beginning to question whether you are genuinely searching for treatment? If you keep googling and fixing on one random piece of research data after another without any context, you will never get round to actually doing anything.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 27 Jul 2021 at 12:06

I vaguely remember imaging at the Radboud being mentioned several years ago but it may have been on an American forum on which I am a member. I can't recall it having been mentioned on this forum in recent years. They do advanced scans there and seem to have developed one using 'Combidex' as an agent. They were expensive. Though not cheap, the 68 Gallium PSMA scan has become more widely accepted and in due course it is likely that the 18 DCFPyl scan on trial in the USA and Canada will become widely used - https://clinicalconnection.hopkinsmedicine.org/news/psma-pet/ct-with-pyl-reaches-a-key-milestone-toward-approval

So, as with various treatments, scans are improving. Very few our UK members, comprising the vast majority on this forum, have gone abroad for treatment or scans and only then coupled with treatment.

Whilst I appreciate you ultimately want the best and appropriate treatment, I do agree that it would be sensible to go to a top hospital and get a treatment plan rather than get hung up on the latest scan which you may not need or for which you may not be a suitable candidate.

Edited by member 27 Jul 2021 at 12:07  | Reason: Not specified

Barry
User
Posted 28 Jul 2021 at 12:05

Hi, it probably is better to keep adding to this thread. The questions all relate to more or less the same thing, and it is handy to be able to refer back to previous comments, which one can then scroll up to rather than have to search for them. 

Anyway, if you are worried about mets then go for a treatment involving EBRT. Speak to your consultant and ask whether it is appropriate to go for whole pelvis RT in the hope you will catch some mets if they are out there; though of course cause some needless damage to other organs if they are not. 

As I said in my previous post (which is on this thread, so easy for all to see), no matter how good the scan you will still be worried about micro mets so actually the scan is pointless. 

We all like certainty in life but sadly with cancer you can't have that. Go with whatever the professionals recommend. If they recommend two treatments and you can't decide flip a coin. 

 

Dave

User
Posted 29 Jul 2021 at 08:34

Four years ago I had a similar situation with salvage RT , any distant Mets meant no SRT. It has changed slightly in recent years.

Thanks Chris

 

Edited by member 29 Jul 2021 at 13:09  | Reason: added meant

User
Posted 29 Jul 2021 at 10:48
They will sometimes do SBRT in some situations now following unsuccessful RT. Much will depend where the mets are found and how many there are. They want to avoid dose paths that were used when administering the previously given EBRT.
Barry
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User
Posted 27 Jul 2021 at 01:37

I found the video quite interesting, but it is certainly not easy to follow. To tell the truth I prefer videos of cats doing silly things.

I requested copies of my own MRI scans. I could just about make out the anatomy but could not do any real interpretation of them. In this video Dr Jalf does a lot of interpretation of images taken with different techniques. Amazing that he can spot slight differences in brightness and conclude a lymph node is cancerous.

The later part of the  video showing hifu(?) being guided by MRI showing the whole prostate being destroyed in a very controlled manner was great.

As Barry said in one of your earlier threads most people on this site are uk based and treated on the NHS I don't think many of us will be able to better the research you have already done in this area.

On one of your previous threads you listed your treatment choices. Assuming you go for one of these excellent scans. How will it affect your treatment choice?

In the video he says he can now detect cancerous nodes down to 2mm, but presumably you will be worried about the 1mm cancers which he can't detect. 

If no micromets are discovered, will you book a scan somewhere else in the hope that someone else has a bigger and better scanner and they might find some?

If micromets are discovered, will you abandon any direct treatment of the prostate and just go on HT for the rest of your life?

Dave

User
Posted 27 Jul 2021 at 08:42
NanoMRI has been around for years - Swiss research project ran from 2012 onwards I think, and it is available in Israel?

It is quite irritating that you keep starting new threads rather than just adding to your previous one. I am beginning to question whether you are genuinely searching for treatment? If you keep googling and fixing on one random piece of research data after another without any context, you will never get round to actually doing anything.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 27 Jul 2021 at 12:06

I vaguely remember imaging at the Radboud being mentioned several years ago but it may have been on an American forum on which I am a member. I can't recall it having been mentioned on this forum in recent years. They do advanced scans there and seem to have developed one using 'Combidex' as an agent. They were expensive. Though not cheap, the 68 Gallium PSMA scan has become more widely accepted and in due course it is likely that the 18 DCFPyl scan on trial in the USA and Canada will become widely used - https://clinicalconnection.hopkinsmedicine.org/news/psma-pet/ct-with-pyl-reaches-a-key-milestone-toward-approval

So, as with various treatments, scans are improving. Very few our UK members, comprising the vast majority on this forum, have gone abroad for treatment or scans and only then coupled with treatment.

Whilst I appreciate you ultimately want the best and appropriate treatment, I do agree that it would be sensible to go to a top hospital and get a treatment plan rather than get hung up on the latest scan which you may not need or for which you may not be a suitable candidate.

Edited by member 27 Jul 2021 at 12:07  | Reason: Not specified

Barry
User
Posted 28 Jul 2021 at 11:42

Originally Posted by: Online Community Member
NanoMRI has been around for years - Swiss research project ran from 2012 onwards I think, and it is available in Israel?

It is quite irritating that you keep starting new threads rather than just adding to your previous one. I am beginning to question whether you are genuinely searching for treatment? If you keep googling and fixing on one random piece of research data after another without any context, you will never get round to actually doing anything.

 

Hello, I'm sorry. Each questions is specific and that is why I make a separate thread. Is that not allowed? If not, I will stop making the threads.

 

Yes, I'm genuinely search for treatment of course. I'm just extremely worried of mets and that doctors might not find them. I can't make up mind between brachy+EBRT and Cyberknife (SBRT). I can't understand why SBRT is compared in efficacy with brachy, when they don't add EBRT in Cyberknife. 

________________________

59M, Gleason 4+3, PSA7.8, T2C.

DaVinci Surgery or HDR Brachytherapy+EBRT or Cyberknife(SBRT)?

User
Posted 28 Jul 2021 at 12:05

Hi, it probably is better to keep adding to this thread. The questions all relate to more or less the same thing, and it is handy to be able to refer back to previous comments, which one can then scroll up to rather than have to search for them. 

Anyway, if you are worried about mets then go for a treatment involving EBRT. Speak to your consultant and ask whether it is appropriate to go for whole pelvis RT in the hope you will catch some mets if they are out there; though of course cause some needless damage to other organs if they are not. 

As I said in my previous post (which is on this thread, so easy for all to see), no matter how good the scan you will still be worried about micro mets so actually the scan is pointless. 

We all like certainty in life but sadly with cancer you can't have that. Go with whatever the professionals recommend. If they recommend two treatments and you can't decide flip a coin. 

 

Dave

User
Posted 28 Jul 2021 at 21:16

Both SBRT(Cyberknife) and Brachytherapy doctors told me that the PSMA/PET and nano-MRI scans are not really needed. But they weren't 100% sure about it. In fact, they hadn't even heard abut nano-MRI.

This makes me wonder. What is the % chance of these scans proving to be useful in affecting treatment in my case.

Let's say a small chance that nano-MRI / PSMA-PET combo yields information on mets, doesn't it change bracyhtherapy+EBRT treatment dramatically? Doesn't it change Cyberknife treatment (additional aiming required at the met area)?

If yes, isn't it worth it? How do I know % wise how much of certainty will be increased?

My PSA is 7.8 in last reading, so that is argument many use: low PSA means low chance of mets, yet when I enter my data in https://www.mskcc.org/nomograms/prostate prostate pre-surgery nonograms  I get pretty high % of lymph node mets. 

If the % is high there, then wouldn't additional scans be necessary to exclude this possibility?

Please enlighten me about this.

________________________

59M, Gleason 4+3, PSA7.8, T2C.

DaVinci Surgery or HDR Brachytherapy+EBRT or Cyberknife(SBRT)?

User
Posted 28 Jul 2021 at 21:48
You seem to be missing the point. If you push for more detailed scans, or find someone that can do nano-MRI, then what? If they find some tiny met somewhere you lose your chance of radical treatment and have to settle for life-long HT. What would you prefer- to have radical treatment and then a possible (but by no means certain) recurrence a few years down the line OR to never have the chance of radical treatment?
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 29 Jul 2021 at 07:17

Originally Posted by: Online Community Member
You seem to be missing the point. If you push for more detailed scans, or find someone that can do nano-MRI, then what? If they find some tiny met somewhere you lose your chance of radical treatment and have to settle for life-long HT. What would you prefer- to have radical treatment and then a possible (but by no means certain) recurrence a few years down the line OR to never have the chance of radical treatment?

They will not be allowed to do radical treatment if there are mets detected?

Would you still not be able to do radical treatment?

________________________

59M, Gleason 4+3, PSA7.8, T2C.

DaVinci Surgery or HDR Brachytherapy+EBRT or Cyberknife(SBRT)?

User
Posted 29 Jul 2021 at 08:34

Four years ago I had a similar situation with salvage RT , any distant Mets meant no SRT. It has changed slightly in recent years.

Thanks Chris

 

Edited by member 29 Jul 2021 at 13:09  | Reason: added meant

User
Posted 29 Jul 2021 at 10:48
They will sometimes do SBRT in some situations now following unsuccessful RT. Much will depend where the mets are found and how many there are. They want to avoid dose paths that were used when administering the previously given EBRT.
Barry
User
Posted 31 Jul 2021 at 20:23

Should I get PSMA/PET + Nano-MRI if my nodal met risk is 7.4% according to Briganti nomogram?

M59, Gleason4+3, T2C, PSA7.8

 According to the Briganti nomogram I have 7.4% risk for nodal metastases. 

Nano-MRI can detect mets down to 2 mm in lymph nodes.

Current CT scans and MRIs don't show any mets outside prostate, but they are not as good as PSMA/PET+Nano-MRI combo.

Question is, is it worth it doing this?


Would you do it?

________________________

59M, Gleason 4+3, PSA7.8, T2C.

DaVinci Surgery or HDR Brachytherapy+EBRT or Cyberknife(SBRT)?

User
Posted 01 Aug 2021 at 11:01
I had "whole pelvis" EBRT precisely because it was felt that there was a high probability of undetectable spread to pelvic lymph nodes. But my PSA was 31, not 7. I had relatively few side-effects from the treatment.

Better to get yourself treated than dither for months about what treatment to have. All the mainstream treatments are effective.

Best wishes,

Chris

 
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