Friday, 14 August 2015

Imaging protocols


Do you know much about the efficacy of various MRI protocols?  Specifically Swedish likes to use perfusion studies, UCLA didn’t have much to say about perfusion studies but likes F-DOPA PET ( I realize a PET is not an MRI), MD Anderson seems to like MR Spectroscopy.  Then there is field strength.  Swedish uses a 1.5 Tesla field strength and MD Anderson is 3 Tesla.  I forgot to ask UCLA what they were using.  Any research you know of that suggests one approach is best?  Or is it more likely that each has much to offer and it’s a matter of preference with each institution.

By the way, we had our appointment at UCLA.  We were supposed to meet with Dr. Cloughesy but he was busy so we met with Dr. Lai.  We were very impressed.  We will be switching to UCLA from MD Anderson.  We are impressed with MD Anderson as well, they are just not open to other approaches, including Optune.  UCLA is neutral on the cocktail approach, but encouraged us to continue with what we are doing because Jeremy is responding so well. 



  1. Mike,
    I have to admit that imaging has not been central to my research thus far. I know very little about perfusion or MR spectroscopy techniques. I have done a little reading on amino-acid based PET scans such as FDOPA-PET and FET-PET. These sorts of PET scans are intriguing in that they can show areas of metabolically active tumor, with good contrast, as normal brain has minimal uptake of these tracers. This makes them more useful for brain tumors compared with FDG-PET, as normal brain already has high glucose uptake. Unfortunately these newer amino-acid based PET scans are not very common in the US outside of a few centers such as UCLA.

    Glad to hear UCLA is a good match for you. I have a very good impression of the brain tumor team there.

  2. We had the FDOP-PET for my son in Dec after first MRI after RT and chemo first round showed progression or recurrence suspicion. This was actually a clinical trial but the doctor kindly gave us the results of the test and it was negative for progression or recurrence -- indeed he did have progression - so my confidence in this type of scan of course is poor. The spectroscopy scan at MD Anderson showed progression. We went back to our NO who initially said he suspected progression -- we lost some time there waiting to initial new treatment and he had to have a second surgery in January that left him paralyzed.

  3. Aunt Jo, do you have a NO at MD Anderson that is accepting of the carpet-bomb cocktail approach? We loved ours but he is retiring.

    1. Unfortunately Joan's son Michael passed away in February. From what I remember she had to do a lot of convincing to get his NO to prescribe off-label.

  4. I'm so sorry to hear that. Losing your child is a pain that is indescribable.