MRI With Contrast

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My husband had an MRI but they couldn't find a suitable vein so performed the procedure without contrast. I feel concerned because the image clarity will be greatly reduced. He has given blood for testing etc., many times and sometimes they have difficulty with finding his vein, but they don't give up.

Ssames, I can understand your concern. I found this study comparing the MRI with and without contrast.

- Comparison between multiparametric MRI with and without post - contrast sequences for clinically significant prostate cancer detection https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442176/

The researchers found that exams with and without contrast were similar for detection of clinically significant prostate cancer on MRI.

The study found similar results
- Is contrast enhancement needed for diagnostic prostate MRI? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5503975/
"gadolinium-based contrast agent seems not to be strictly necessary in the detection and localization of prostate cancer."

Also keep in mind that your husband's doctor's use multi diagnostic tools to inform them about the diagnosis and treatment plan. Did you share your concerns with your husband's oncologist? Did your husband get a diagnosis of prostate cancer?

Yes, a biopsy showed prostate cancer and the MRI was the next step. We will meet again with the surgeon next week. Hopefully the MRI will show exactly where the cancer is.

I look forward to hearing what you learn after talking with the surgeon, ssames.

IMHO, the quality of the MRI may have to do with the use of a multi-parmetric device. My local hospital was 'trialing' the multiparametric apparatus. This is relatively new (3 years), and I knew of other folks who went to Palm Desert for a multiparametric MRI. I ended up going to Mayo in MN for my biopsy which was guided by the MRI data and ultrasound. I believe they did 23 cores. My local urologist had suggested an in office (ouch) ultrasound only guided biopsy with nine cores. And FWIW my local hospital's multiparametric MRI (using a 'focusing coil' (~kind of strapped to my public bone) had good enough results for Mayo to not repeat it before the biopsy. I don't remember it being done with contrast. The quality of the MRI and the extensiveness of the biopsy may open the possibility for some treatments, such as focal treatment for a distinct tumor (cryo, sound, laser). Hope that helps

"meet with the surgeon" makes me a little leery depending on the surgeon's knowledge of options other than surgery. In a book I read two years ago, the author went to four different physicians each of whom said something like "You are the poster child patient for getting the type of treatment that I offer" Unfortunately, very qualified and experienced doctors often know little of treatment modalities outside of their specialization. Some facilities offer many of these modalities and a physician may meet with you to suggest to review the upsides and downsides of each treatment option.
Treatment options (don't assume my list is comprehensive) include: prostatectomy (robot guided or not), xray (photon) treatment with varied focused beam methodologies, proton beam treatment (my personal choice), brachytherapy ( radioactive seeds inserted in the prostate), and focal ablations (cyro, heat, sound). Many will be accompanied with ADT (androgen deprivation therapy - lowering testosterone). The length of time for ADT may vary from a short prophylactic period, to a longer period when PSA numbers, biopsy results, or post surgery biopsy suggests a higher risk of metastatic disease.

No one answered the guy's question. Just a bunch of contrast sympathizers. I'm adamantly opposed. I will wait until the first part is done, then refuse the injection.

I had the MRI with contrast. Did not have any side affects. I believe the tech said would feel some coldness or was in warmness in pelvic area saying I would think I was urinating but to believe him I was not it was just the contrast.

I see some comments below about MRI and Biopsies. The plan my urologist followed was a DME, and genital exam. Then a MRI with contrast and a probe (is suppose to make prostrate stand out more). That showed areas of concerned thus the next step was biopsies using a procedure called MRI/Fusion.

That biopsies is where I got my Gleason score for the cancer areas found. It was then on to consultations with oncologist/radiologist. I think that all these tests are good to help find if problem areas but the only confirmation is having a biopsy. I had mine done transperinal and with anesthesia. Had no issues or complications. Even the transperinial area was not sore. Guess I had a good urolgoist. He was very experience and had been doing these for Mayo Jacksonville Clinic for years. It is why I and others really recommend going to a major provider for testing and treatments.

It is normal to have concerns about contrast and or tests. But in my opinion the worry about contrast complications would be rare but they are always there regardless of rarity. I have had contrast injections many times for other type test, xrays, CTs, PET Scans, bone scans, and this MRI. I did not have an side affects nor have any of my friends had them.

Of course everyone is an individual so what I or another has is not necessary what you will have. Talk to your urologist, oncologist/radiologist and get answers to your concerns via professional medical advise. If you still concerned get second and third opinions AND remember there is NOTHING wrong with getting second and third opinions.