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CT vs. MRI. Any preferences?

Forums General Melanoma Community CT vs. MRI. Any preferences?

  • Post
    MovingOn
    Participant

      I’m getting my first scan since starting Keytruda. It will be a CT scan. However, all my previous major scans have been MRIs. This one started out as an order for an MRI which my insurance approved. Then the Radiology department consulted with my Oncologist and the order was changed to a CT. My insurance questioned this change but my Oncologist discussed it with them and it is now approved.

      My only hesitation with a CT scan is that in May I had a CT scan because of symptoms of hypophysitis (I was on Ipilimumab at the time). They came back and said the CT showed everything in my brain was fine. I then had an MRI three days later and it said my pituitary was more than double the size it had been 3 months earlier (hypophysitis). So I lost all confidence in CT scans at that time. Hopefully my loss of confidence was misplaced and there is nothing about a CT scan which would make it inferior at identifying melanoma progression compared to an MRI. I guess I’m just venting to get some energy out while I await my results.

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        cancersnewnormal
        Participant

          My doc's routine for me has been CT for chest/ab/pelvis, but MRI for the brain. MRI shows brain structures in better detail. The brain is a delicate location, so one would want to catch/track any progression there tightly. MRI's will pick up very small "spare bits" that can't be well visualized with a CT. With the body, a CT is typically enough for spotting "weird" locations to keep eyes on. CT's are less expensive, which is why they are insurance company's top choice. They're also much faster than an MRI, buuuuut… also have that nasty radiation docs and patients would prefer to limit exposure to. If it is a brain scan you're questioning, I'd personally push for an MRI. My initial brain CT (at the ER following the seizure that started this mess) showed "3 possible areas of suspicion"… the MRI ordered an hour later, showed 5 mets. If it's a routine follow up scan of your body… the CT is pretty much standard.

          MichelleRHG
          Participant
            I also have CT of chest, abdomen and pelvis (CT rather than PET while on immunotherapy since that tx can cause inflammation which lights up on PET) and MRI of brain.
            jennunicorn
            Participant

              Full body MRIs are not the standard scan, CT, PET, and brain MRIs are the typical scan types majority of us get. They should not have used a CT to check for hypophysitis, it should have been a brain MRI from the get go if they were looking for that specifically. CT of the full body shouldn't worry you and is very effective at being able to see if anything is there that shouldn't be. Totally understand the hestitation but hopefully our replies will put some faith back in CTs for you.

              My next scan is in a week, I get PET/CT combos every time, just the way my docs do it. Keeping positive thoughts we both have good scans for the holidays!

              TexMelanomex
              Participant

                Moving,

                Like others have mentioned…I also get CT of the chest, abdomen, and pelvis but MRI of the brain. CTs were able to catch even really small things in my abdomen (described as "punctate") and later as they increased in size to 1cm (so not very large) but CT spotted these things nonetheless. The MRI, as explained to me, is much better for the brain. Hope this helps & CT seems to be the preferred scan for everything except the brain. I'm wishing you nothing but awesome things on your scan results. Warrior on!!

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