Frequency of post-surgical MRIs???

[JerseyGirl2]

My translab procedure was done in January 2008, at which time the surgeon assured my family and me that the AN (about 1.3 cm.) had not been sticky and had been completely removed. I was requested to have an MRI (with contrast) around the first anniversary of my surgery, which I did. My local doctor pronounced it "clean" (i.e., no evidence of an AN) and I got the same report from my surgeon upon his receipt of my MRI cd. He told me in his letter that I should have a follow-up MRI in about five years.

Has anyone else been given similar instructions? I certainly understand that ANers who are "waiting and watching" need to have frequent MRIs, as well as those who've undergone one or more of the various radiation treatments. But it seems as though there are frequent posts on the forum from people who are scheduling MRIs on their second, third, etc. surgical anniversaries. Are these instances where it's known, or suspected, that remnants of the AN were "left behind" after the surgery? Or are some doctors just more inclined than others to prescribe annual MRIs for a number of years?

I'm certainly not complaining about having to wait five years (just hope I can remember!), even though I'm among those for whom the MRI causes no discomfort or anxiety. I should add that I had my surgery done at House Clinic .... so I think I can safely assume that I was given good advice!!!!! Is this just another one of those instances (like length of time before flying after surgery, implant of BAHA abutment at the time of surgery versus a few months later, etc., etc.) where AN surgeons seem to disagree? I would really be interested in knowing of other surgery patients who've been advised to wait five years for the second follow-up MRI.

Thanks!

Catherine (JerseyGirl 2)

[Keri]

Hi Catherine,
I was wondering about this as well. I'm 8 weeks post op for translab. At one point, someone somewhere (maybe on the hospital release sheet) put down for a follow up MRI at 6 weeks. I had a follow up check up with the neurosurgeon, but he said I didn't need an MRI until my one year anniv. But others do get them more frequently. I was assured all my tumor came out. All is well here with recovery, but I want to make sure nothing's up with the other side on a somewhat regular basis.

Keri

[OTO]

I had my middle fossa surgery at House Ear Clinic/St. Vincent's in May 2007.   I had an MRI about 6 mos later (Nov 07) and an audiogram.  The House Clinic sent me a postcard reminder.   I sent my MRI film to Dr. Slattery, and he sent me a letter telling me there was no regrowth, and that I should wait another 2 years for another MRI.    They had to leave a little bit of tumor material behind because it was stuck to the nerve.

[EJTampa]

In my case, they said they got all the tumor out, and will wait one year for my first MRI.  The doctor said he likes to wait a year for the baseline MRI because sometimes scar tissue can look like tumor regrowth.  I have no idea how often he will want them after that.
 
Ernie

[Jim Scott]

Catherine ~

Like most aspects of ANs, there doesn't seem to be any 'standard'.  The recommended frequency of MRI scans appears to be an very individualized decision that varies from doctor to doctor and patient to patient. 

In June, 2006, I underwent a subtotal resection (retrosigmoid approach), followed 90 days later by 26 FSR treatments.  All went well.  My neurosurgeon ordered an MRI at 6 months post-op and it was 'unremarkable'.  He ordered another MRI 6 months later - for a total of 2 scans in 12 months.  When the 1-year MRI scan showed some slight increase in size of the remaining tumor, he  ordered another MRI 6 months later, as a precaution.  That scan showed a reduction in the tumor's size, indicating that the earlier 'growth' was actually swelling, as he had suspected.  Because this is a very conservative doctor, he didn't want to take the chance that the remaining AN was growing again.  It wasn't.  Six months after this, just past my 2-year surgery 'anniversary', I underwent another MRI scan.  This one showed definite necrosis and slight tumor shrinkage.  My doctor then informed me that based on my last MRI results and the fact that I had met every goal he had established for me (I'm symptom-free, no complications) an annual MRI would be sufficient from this point on.  The previous follow-up MRI scans were all taken with contrast and at the same MRI center on the same machine.  All these MRI scans, and yet I had an excellent surgical outcome as well as no ill effects from the radiation.  However, I trust my neurosurgeon and believe he has just been very cautious and didn't want to risk missing any re-growth or other problem by foregoing frequent MRI scans.

Based on my experience and the collective experience of the AN patients who've posted on this issue in the past, I have to draw the conclusion that doctors treat each AN patient on an individual basis (as they should) and order MRI scans as they believe is necessary.  Some are probably more cautious than others, like my doctor, but unless symptoms crop up unexpectedly, I'll assume the doctors treating AN patients use sound judgment and are ordering - or not ordering - MRI scans in the best interests of their patients.   I would simply trust my doctor and if he wants you to wait five years for your next follow-up MRI, go with that.  Frankly, after all the MRI scans I've had, I'm happy just to be able to wait 12 months between them at this point.  If and when my doctor allows me to go 60 months between MRI scans, I"ll be ecstatic. 

Jim

[kenneth_k]

Hi Catherine.

I was told the exact same message, follow up at 1 and 5 years.
By mistake (different hospitals not coordinating closely) I had my 1 year follow up at 6 months. Nevertheless it was clean. My doctor is happy and so am I

Regards, Kenneth

[krbonner]

I also have been told that all vestiges of my tumor have been removed.

I had an MRI at 1 year post-op, and the next one (coming up this fall) will be 2 years later - making it 3 year post-op.  If I'm remembering correctly, my next one (assuming the one this year is clean) will be 5 years from now, probably with another one every 5 years for pretty much the rest of my life.  I'll have to see if those recommendations change given that I'm currently bathing my body with all sorts of hormones from my pregnancy...

Katie

[Dog Lover]

My AN was not sticky and was totally removed. I had a baseline MRI done (in addition to antoher hearing test) at my 4 week post-op appointment and was told that I will have another MRI at my 1 yr post op appointment. If I remember right, I think the next one is at the 5 year mark.

Cathy

[leapyrtwins]

I was told to have a MRI annually and will be going for my 2nd next month or the month after.

I think when we first talked surgery my neurotologist told me I'd have annual MRIs for the first five years and then periodically thereafter, but I'm not 100% sure of that.

Guess I'll see what happens when I get to year five.

Jan

[Angela]

I had an MRI on anniversaries 1 & 2.  Dr said I didn't need #3 because I had just had one before nerve-splicing surgery. 
However, at year #4 he noticed "possible" regrowth/residual that was thought to be scar tissue at yr 2.  Due to my new status of "watch & wait", I need another MRI at yr 5... otherwise I would've been done for a few years.

[cin605]

I have had 3 since  surgery last june & am scheduled for another in june so its been every 3 months.They said they got all tumor but mri at 3 months showed new enhancement in post-op bed...they are watching to seee if its scar tissue or new growth.
Does anyone know if there is harm in getting too many mris??

[cin605]

Answering my own questions again...I went to the archives & found a topic on dangers of mri.Got the info i needed,thanks Jim!

[CHD63]

At the time of my retrosigmoid approach surgery the neurosurgeon told me he had removed all of the tumor.  I was instructed to have an MRI in three months.  However, my insurance will only pay for one every six months.  Since the diagnosing one was a month before surgery, I actually had my first MRI at 5 months out.  It was read as "there is some enhancement of the intracanicular portion .... this may be due to post-op change or residual tumor."

My next MRI was on the first anniversary of my surgery, February, 2009.  It was read as "enhancing area in the intracanalicular portion of the 7th and 8th neural complex compatible with a residual intracanalicular tumor."

My neurosurgeon feels it is most likely scar tissue and is comfortable waiting another year for the next MRI.  Given that I had an unusually rapidly growing AN in the first place, I am trying very hard to put it in the back of my mind.

As others have said here on the forum, it is rare for it to grow back after appropriate treatment so I am counting on whatever it is to be receding (or gone!!) by a year from now.

On the first consultation, I vaguely remember something about annual MRIs for 3 years, then every 5 years for an indeterminate amount of time.  But obviously from the previous responses, there is quite a range of "usual."

Clarice

[Kaybo]

Of course, mine was a LONG time ago so things have probably changed.. but it seems that the 1st year, I had them every 3-6 months and then yearly for the next 4 years.  He said after 5 years, I didn't have to get them anymore, but it works out that I get them about every 5 years now...just for a little peace of mind!  It always seems that something is happening and i have headaches about then and so it is a good reassurance that there is still nothing there...

K

[lori67]

I had a one year post op scan done and now I don't have to have another one until I hit 5 years post op.  I was a little concerned at first about waiting that long, but I was told they got it all out, my one year follow up was perfect and at least now I know what symptoms to be aware of!  I certainly wouldn't hesitate to ask for a repeat MRI if I noticed anything out of the ordinary before my 5 year point.

Yet another area where doctors want to do their own thing!

Lori