CT vs MRI

Hi, Lainy
May I ask where is your GIST located ? in the esophagus ;or in the stomach upper(fundus) or lower part near the pyloric opening or locate in the upper GI(small intestine) or lower GI tract(ie,colon)? and is your GIST Thanks for asking this interesting question.
God bless.

Hi, Lainy

I will do a research first if you don’t mind;but I will be prompt.

God bless.

Hi,

Additional info for the CT vs MRI has been added on 4/22/2011.
I think it was on my reply on “blood transfusion”under intro or discussion on this web site..In addition, ultrasound is better in providing better image for gallbladder.But ultrasound result is more dependent on the operator skills as compare to CT and MRI.
Apart from that, Ultrasound is an inexpensive FIRST step widely available around the world for people who worry about CC or liver lesions and want to check them out for their own health needs.
EARLY DETECTION is the key for treating this disease.
I also updated my message about treatment on itching under the reply for
” Help itching….” either on introduction or general discussion section.
and I just finished update the info. on Complementary and Alternative (CAM).

Here is the CT vs MRI reply; the update about itching will appear after .
The CAM update is on this web site under Alternative Treatment section.
God bless.

Hi,
Side effects of blood transfusions are fever and transfusion allergic reactions such as itching ,rash and shortness of breath ,which if occur, will be in the beginning of the transfusion and generally will be managed by premedicated with Tylenol and Benadryl(antihistamine.) before transfusion.
CEA and CA19-9 are tumor markers ,along with ALK phosphatase, to MONITOR the progress of the chemo treatment. Doctors are looking for a TREND rather than single value ,together with the Cat Scan result to determine the course of treatment. If you have intrahepatic CC the values may NOT be as useful as if you have extrahepatic CC. for the CA19-9.
If you have advance cancer or cancer metastasized ,CEA is more likely to have higher value;a steady rising CEA value often is the first sign of tumor recurrence.
If you have CC in your liver(intrahepatic),you will most likely to have a much lower CA19-9 value than if you have the CC in or near the main bile ducts .
CA19-9 is ordered for checking bile duct blockage and that is why after putting in a new stent the CA19-9 will be lower.

Cat Scan is for diagnosis purpose.(including initial diagnosis and follow up after resection or chemo treatment for CC. Both MRI and Cat Scan are used to look for structural changes.PET scan is used to look for functional changes of the CC.
According to one study compared 20 intrahepatic patients images ,the extent of the tumor enhancement was similar with both MRI and CT methods,however the relationship of the tumor to the vessels and surrounding organs was more easily evaluated on CT scan as opposed to MRI.For perihilar tumors CT also has limited sensitivity for extra regional nodal disease(ie metastases to the periaortic,pericaval or celiac artery lymph nodes.)—from uptodate .com
PET Scan allows visualization of CC because of the high glucose uptake of the bile duct epithelium(the lining )– the “Hot spots” will light up on the PET scan.
A PET scan therefore can help to tell if the bile duct obstruction is caused by a cancer or not.PET scan can also be useful in determining the cancer may have return after treatment.
Some hospitals equipe with machine that is able to perform both A PET and CT scan at the same time(PET/CT scan) ;this allows the radiologist to compare areas of higher radioactivity on the PET with the appearance of the that area on the Cat scan. But according to the radiologist I talk to , A (PET/CT scan ) is not the SAME as if you take them SEPARATELY. Remember CT is for structural and PET is for functional visualization. That is why sometimes doctors order a PET scan on this 3 month checkup and on the next checkup, he/she orders a CAT Scan with contrast instead.

Additional info. from uptodate.com as of 4/22/2011.
MRI and CAT SCAN (CT) have similar resolution for liver lesions.
CT has been considered to be superior to MRI for evaluating extrahepatic organs and calcifications. MRI is more specific than CT for differentiating cavernous hemangiomas,diffuse hepatic steatosis and focal fatty infiltration.Also MRI should be reserved for the evaluation of lesions less than 2 cm,or lesions located adjacent to the heart or to major intrahepatic vessels.If you are allergic to the IV iodinated contrast agent used for CT,then MRI is the alternative because the contrast agent used is different than CT.
I hope the above info. helps.

Last edited by PCL1029 (Yesterday 23:43:06)

Online
Hi,
As always,consult doctors for advice first;this is strictly for informational purpose only.
Of course,the most important thing is to treat the underlying problem first which is the buildup of the bile acids due to bile ducts obstruction.(ie; stents)

For mild cholestatic pruritus ,nonspecific measures such as warm baths,emollients and antihistamines should be considered as the first-line therapy.
OTC emollients such as Benadryl cream,hydrocortisone 1% cream,Calamine lotion,Aveeno,lanacane and sarna cream will provide some relief.
Rx emollients such as hydrocortisone 2.5% ,fluocinolone, triamcinolone, halcinonide , betamethasone and clobetasol (from low to high potency in order) are available thru prescription for short term use.
Systemic antipruritic medications such as Benadryl 25mg-50mg can be used at night. and cyproheptadine (Periactin by Merck) three to four times daily may be useful when sedation is to be avoid.
Benadryl is over the counter and cyproheptadine may required a prescription in the States.
Cholestyramine (Questran),Colesevelam(Welchol) and colestipol(Colesid) are called bile acid sequestering agents which are prescribed for lipid lowering purpose. ( needs prescriptions in the States).
In patients with biliary obstruction, these agents reduce the serum bile acid level by binding to the bile acids in the intestine,decrease bile acids reabsorption ,reduce excess bile acids deposited in the dermal tissue with resultant decrease in pruritus (itching).The one that used more frequently is cholestyramine 4gm 1-2 times daily to a maximum of 24gm(6doses) per day.
Side effects of the bile acid sequestering agents included nausea,bloating and cramping;increase liver enzymes . Colesevelam(Welchol)-3tablet twice daily- is better tolerated and less likely to cause GI side effects.

Newer topical agent like naloxone lotion is in phase II clinical trial for treatment of pruritus accompanying cutaneous t-cell lymphoma by Elorac,Inc. It may be of value to CC patients as well.
God bless.
Additional info: from uptodate.com
Better efficacy of taking bile acid sequestering agents may be increased by taking a dose before and after BREAKFAST in patient with an intact gallbladder to enhance the excretion of the agent that cause itching.
Also rifampicin 150mg-300mg twice a day or oral naltrexone,setraline 75-100mg(Zoloft) daily can be tried if other measures fail.
Other medications like phenobarbital,colchicine and methotrexate as well as paroxetine(Paxil) are also being mentioned.
IF you are using opiate narcotics to control pain such as Fentanyl,Oxycodin,codeine,Demerol,propoxyphine(Darvocet),ultram,morphine,methadone,hydromorphone(Dilaudid),hydrocodone(Norco,Vicodin and Percocet etc) ,you should not take naltrexone as well as the the lotion I mentioned above. Because it is an opiate antagonist, and it will counteract the opiates to control your pain.All of them required prescriptions in the States.

As always,this is strictly for information purposes only.so consult your doctors first.

Last edited by PCL1029 (Yesterday 20:44:42)

I have never had a PET scan but have used both CAT and MRI’s. In my case neither of the scans has shown anything definitive as I do not have any solid tumors . The radiologists do seem to have discerned slightly different information for each however which combined was either reassuring or raised some questions.

My laymans view is that using a different imaging tool to compare with the MRI’s you already have may be helpful. You can always repeat an MRI later.

-Peter