one year MRI shows increase

[Alison]

Hi, just got my copy of my one year post SRS MRI in the post. This time there is a measuring tool in the software. I measure it to be 17.5mm by 10.8mm. Before SRS it was just under 15mm by 10mm by 8 mm. Can anyone tell me what they had as an increase at one year post SRS. Is this normal?I still have to wait to be contacted by the docs, which may be a while, and there is no radiologists report with the cd. I have had worse symptoms since SRS especially this past month. Alison x

[Alison]

just to add, I also printed out the before and after same sized images and overlayed them . The latest one does come out bigger on this method as well. I'm not an expert but I've been meticulous in my measurements till I'll boss eyed :0)It looks nearer the brainstem too. It would explain my worsening symptoms, just hope its swelling not growth. Have many people had 2mm increase that then went down after one year? Alison x

[Jim Scott]

Hi, Allison ~

Post-radiation swelling is typical and should be expected.  I underwent FRS on a debulked AN and experienced swelling at my six-month MRI.  The swelling had disappeared by the next MRI scan and by 24 months the remaining tumor showed some slight shrinkage and the beginnings of necrosis. 

Although only doctors can offer you a professional answer to the enlargement of your AN on the MRI scan, I suspect it is normal post-radiation swelling.

Jim

[arizonajack]

Hi, just got my copy of my one year post SRS MRI in the post. This time there is a measuring tool in the software. I measure it to be 17.5mm by 10.8mm. Before SRS it was just under 15mm by 10mm by 8 mm. Can anyone tell me what they had as an increase at one year post SRS. Is this normal?

A while back I found this series of images on the internet and have kept it handy because image A shows an AN that's roughly the shape and size of mine.

http://ars.els-cdn.com/content/image/1-s2.0-S0360301612004336-gr3.jpg

The images show the progression of the AN over a 36 month post-SRS treatment.

Image B is similar to my AN at the 6 month MRI. It shows the necrosis and slight swelling.

If your 12 month image roughly resembles image C in comparison with image A, there's a good chance that it's just the normal swelling after the SRS and you could very well have a pleasant surprise at your 24 month MRI.

[TJ]

Allison

I agree with the others that it very may be swelling of the tumor which happens many times.  Also I was told by my doctor that the swelling can also cause an increase in symptoms.

You can talk to your doctor and get their thoughts.  I think after radiation we all think that will be it.  But these little suckers are tough and can cause many different things.

Hopefully you next MRI will give you the results that you hoped for.

TJ

[Alison]

Hi thanks everyone for your words of encouragement and thanks arizonajack for the images. I think mine does look like the 6 month and 12 month image compared to the pre image, ie bigger and more spread out and closer to the brainstem.

I'm in the UK and although I got the CD I got no report with it as that eventually goes to the doc, who will take an age to contact me.

The previous scan CD I had in April was unreadable and I checked it again and it still had no clear image. In fact it makes you think if that if that had been your first MRI they may not have picked it up! But I've not got a copy of the first scan which did pick it up. That was without contrast, so it worked with no gandolinium!

But this time (same hospital and scanner but different radiographer and again no contrast) I found an image exactly comparable to the print out that the oncology doc gave me of the scan with contrast before treatment in Dec 12. Even without contrast on this new scan you can see the AN and there is a tool at the top of the scan image you can drag to measure with. To be sure I printed out the images same size and overlayed them and it does look bigger and closer to the brainstem.

I expect I spent more time taking an accurate measurement than the docs would to be honest!

I think that for a treatment to be considered a fail it is the 2 year MRI showing a 2 to 3 mm increase, which happened to someone I've spoken to in the UK who had surgery at 3 years after GK, poor her. I think about 2/ 3rds of people get no increase or get shrinkage? Trust me to be in the smaller increase group :0(

I now have to wait to get through to the neurosurgeon's dept who I saw a my initial consultation back in Oct 12, who I've not spoken to since as he referred me to oncology. Oncology refer you back to the neurosurgeon in my region of the UK so it all gets a bit complicated and drawn out.

But as my symptoms have taken another turn for the worse in December especially the full ear and tinnitus which makes the balance worse it seems, I hope its not going through more swelling! (or Growth!)

Would be interesting to know the percentage of us who get swelling of around 2mm plus, who then do get shrinkage again back to pre treatment size. Does anyone have that information?

Hope you are all well today.

Alison x

[arizonajack]

Would be interesting to know the percentage of us who get swelling of around 2mm plus, who then do get shrinkage again back to pre treatment size. Does anyone have that information?

Here's one study of 200 patients that answers the tumor control percentage question:

http://thejns.org/doi/pdf/10.3171/2012.7.GKS12783

Another study involved 1000 patients and cites other studies:

http://www.panarabneurosurgery.org.sa/journal/October2008/p1-10%20(551).pdf

[Alison]

Hi,
 Just to explain I've also posted this in my "measurement of MRI" post so apologies if you've read it there, but wanted to reply to Paul W and arizonajack in that post as its related)

I am still awaiting to hear from the neuro oncolgy dept to discuss my MRI one year results but I saw my GP who had access to the MRI report and have an interesting update.

The radiologist has reported  the new MRI as 17 x 11.4 x 8.3, but also measured one I had in April (at 4 months post SRS) as 18 x 13 x 7.8.

The pre treatment MRI was 14.5 x 10 x 8 in Dec 12 before SRS.

I had measured the new MRI myself as 17.05 x 10.08 so I got close!

Bit concerned it went from 14.5 to 18 , being 3.5mm increase  But at least it seems to be down to 17 now, but still 2.5 bigger than pre treatment. So I hope when I speak to the docs they will see that as positive. Symptoms still worse this December/Jan though, even if the swelling has reduced.

So is a 3.4mm (4 month post) to 2.5mm (one year post) OK or common? I was told it was 2mm from brainstem when 14.5 so could it be touching now if 2.5 bigger?

Any opinions would be gratefully received , thanks Alison x