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MRI vs Ultrasound vs Cat Scan

As a stage 3, my first doctor recommended alternating MRI's, Cat Scans and Ultrasounds -- one every six months -- for life in order to monitor my liver. A second doctor was concerned about the radiation Cat Scans produce, and since I'll hopefully be doing these for a long, long time, he suggested only alternating MRI's and Ultrasounds. No x-rays are used in an MRI.

Wondering what everyone else has been told and is doing?
Also, if you know, did you have your mri with and without contrast and the same question for the MRI. I believe when the inject the dye in your arm, that means "with contrast". Not 100% sure here.

In case you get the two mixed up, as I always do -- the MRI is the one where you stay in this long claustraphobic tube for 20-30 minutes while hearing very loud clanging sounds requiring either ear mufflers or ear plugs. A good way to remember which one uses X-rays and which doesn't is that MRI stands for Magnetic Resonance Scanning. In other words, it uses magnets not x-rays.

-- Jim
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Avatar universal
you said....I'll hopefully be doing these for a long, long time,..... No jim any one of those only take a few minutes. You know my stage is 4. My hepo likes the ctscan the best. Says it give a better take on different things. Or he could own stock in the company. Plus mine are always done with dye. Now i gather if a spot showed up he didn't like he would do a mri.
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Avatar universal
Good morning Jim,

I would agree with your dr., I would go between the MRI and ultrasound. My dr uses the ultrasound only with a bx in between.  The MRI w/ contrast is the one they use with a form of iodine for clarity.  I personally would back away from the CAT  ( cat scan).

BEAGLE
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Avatar universal
beagle says.... I personally would back away from the CAT ( cat scan)...... Any real reason, as like i told jim my doc feels it shows more then and ultrasound
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Avatar universal
Cat scan uses x-rays and therefore you're exposed to radiation. This can add up fast if you're doing them every six months for life. MRI uses magnetic technology, no radiation. Safer.
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Avatar universal
My doctor hasn't recommended doing anything yet in regard to checking my liver via ultrasound or anything after the initial test.  Honestly, I don't think he is going to either because he's usually mentionned things we will be doing in the future and hasn't.  I'm a stage 3 too so I'd think he'd have told me.
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Avatar universal
Wasn't sure what you meant by "My dr uses the ultrasound only with a bx in between" ? How often do you do the ultrasounds and MRIs? Also I forgot, what stage are you?
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Avatar universal
Hope you don't use a microwave. :)
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Avatar universal
If you're a stage 3, I'd re-evaluate your doctor's advice. My understanding is that ultrasounds and MRI's are standard protocol for monitoring those with significant liver damage but maybe I'm wrong here.
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96938 tn?1189799858
Last week my doc rx'd both an ultrasound and a CT scan (with contrast). From what he said, he was looking for different things, fluids with the u/s, and any masses/tumors with the CT. BTW, that contrast stuff feels pretty icky going in. We're not yet at the point of a forward-looking maintenance regimine.  However, your question is already on my running list of questions that I will ask when the right time comes. That list seem to be getting longer.
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Avatar universal
cdm says: Hope you don't use a microwave. :)
----------------------------------------------------

Well, I'll tell you one thing. If I'm going to put a piece of liver in the microwave, it certainly won't be mine. But not to worry, CDM, if you keep it up you may be good for a night light one day. LOL.

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Avatar universal
On more serious note, the first doctor said the reason he alternated all three was because each tended to be best for looking at different things. I see my doctor today and if he has a good case for me to have a Cat Scan, I'll listen. But I still think the long-term advice of minimizing cat scans is sound if the doctor is not necessarily looking for something specific and is in a long-term monitoring mode.
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Avatar universal
I'm a stage 0 Grade 1, and I will do the ultrasound then 6 months later the bx; then 6 months later another ultrasound, etc.  I would rotate back and forth between the 2 tests, for awhile any way.  After awhile I would think having just 1 test a year would be fine.

BEAGLE
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Avatar universal
I don't recall whether the "fatty liver" suggested diagnosis was ever verified but if you clear and do not have a fatty liver I wouldn't be testing that often if your blood looks good. I don't test yearly or even every 2 years - I think it will be every 3 to 5 years and I'll get an ultra sound and contrast CT scan or at least I will be offered the opportunity for the tests. Whether I'll get them depends on my blood work and my overall health. I like to stay away from doctors and tests as much as I can and still be prudent about me health. Mike
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Avatar universal
you may be good for a night light one day.
----------------------------------------------------------------
You REALLY think i could shine even that BRIGHT? Come on
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96938 tn?1189799858
'I like to stay away from doctors and tests as much as I can and still be prudent about me health'  Amen!
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Avatar universal
Good point about the fatty liver thing, I almost forgot! I will ask my doctor if he thinks fatty liver is a possiblity -- GGT as of yesterday is double what it used to be but now normal at 40. If my doctor thinks it might be, I'll ask him which is better -- cat scan, mri or ultrasound -- in terms of getting a bead on it.

I'm a bit surprised about your schedule but perhaps there's different protocols for transplant patients. Is there any downside you're aware of with ultrasounds or MRI's other than the stress of too much information, too often?

Thanks.

-- Jim
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Avatar universal
I was/am a stage one and my dr told me I needed regular ultrasounds and testing for a long time if not the rest of my life. It seems that is not just the level of damage, but our bout with a virus that predisposes us to HCC.
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92903 tn?1309904711
What good would CDM be as a nightlight during the day? Stick with the day job CDM.

I've heard they're microwaving blood now as an alternate therapy for HCV.

My doc does the Ultrsound evry 6 mos, mostly looking for lesions, I think. He says we could possibly stop after a couple years, but he would want a needle biopsy to prove sufficient regression first.

I think he likes the CT scan, but doesn't like to spend the money, even if it is reimbursed by Ins. He's concientious that way.
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96938 tn?1189799858
That's the scariest part of all this
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Avatar universal
I got a similar talk except for the preference of adding other tests such as MRI and Cat Scan for different "looks" as posted above.

How often does everyone's doctors recommend alpha-fetoprotein (AFP)testing? I just got my AFP test today which was 1.7 so I guess that's good news as anything under 6.1 is within normal range.

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Avatar universal
Hello and welcome. always glad to  see new people here. Just a little bossy for your first post don't ya think. That is if you can. I mean your name is goofy you know..:)
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Avatar universal
Ditto what CDM said. BTW none of us are doctors here, although CDM sometimes likes to play doctor with the ladies :)
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Avatar universal
First of all the throw the ultrasound out the door.  It just does not give the information that you and your doctor need.  I know before I had my laproscopic biopsy, the doc asked if I had a catscan or an ultrasound.  He would have liked to see the catscan but didn't even want to see the ultrasound.

Second, the MRI is probably good.  However, I had one for a problem with my leg a few months ago and it turned up nothing - other than the fact I had no deep tissue or bone damage.  However, it was not help with my problem - still have it.

Third, what about a biopsy?  I would think that would be the first thing you would do -- maybe in a few months -- just to get the staging done again and see what kind of reversal there is.  Then, I certainly would not submit to 2 cat scans a year if the damage was less than the 3

All anecdotal - no fact - just throwing in my 2 cents, Jim.  I will be interested to see what my doctor's protocol will be after treatment.  I have my suspicions it will be a sincere hand on my thigh and a god bless..... and that will be the end of it.  You see, I don't have a top notch anything - just what is locally available.
friole
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Avatar universal
It's interesting how different docs have different takes on these tests and their frequency. Actually, never asked my current doc about MRIs versus Ultrasound versus Cat Scans -- since other issues have been on my mind while treating. Also, never discussed liver biopsy for same reason, except early-on when I thought a mid-tx biopsy might help us in determining tx length (my biopsy is now 3-4 year old) but he talked me out of that idea.

I did ask, however, a consulting hepatologist regarding post tx biopsy and he didn't seem particularly keen on the idea whether or not I SVRd. There is a school of thought that you only do biopsy when a treatment decision is at stake so what would be the point of a biopsy for me now, assuming I'm SVR? Let's say it goes from stage 3 to 4 -- I don't think they're going to treat me again :) Of course, I'm curious, but that is not supposed to be a good reason for biopsy as it does have risks. That said, if something shows up on one of my scans such as fatty liver, they might use a biopsy to dx further. But for now, my plan is to follow-up with the Fibroscan device, unless of course, my doc talks me into a biopsy.

-- Jim
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