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Encore: MRI of spine best identifier of metastases


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This article is not about current practice.

It is a suggestion to look at changing current practice.

Basically, it says that current practice of:

  • bone scan, then
  • x-rays of unclear areas,
  • then MRI to resolve any spots still uncertain.

is improved if you go straight to MRI of the axial spine.

Two practicalities may limit its implementation:

  • MRI scans are expensive (and not currently (13 December 2011) covered by medicare or health insurance) (maybe $400?); and
  • MRI machines (at least in my personal experience) sometimes have long queues.

But if your PSA is rising and the cause is unclear, if your doctor uses an MRI scan of the axial spine, it may identify metastases.

This may be important because:

  • PBS only covers docetaxel chemotherapy for metastatic prostate cancer; or
  • Some trial drugs are only available with identified metastases.

See the article here:

MRI best metastases



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