Better scans maybe

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beach sunrise
Posts: 502
Joined: Thu Mar 05, 2020 7:14 pm

Better scans maybe

Postby beach sunrise » Tue Jun 15, 2021 2:41 pm

I have been on a mission for better/more sensitive scanning technique and running into so many roadblocks. I have no idea what quality/ slices per segment/timing ect CT scans I've had and its beginning to be like pulling teeth to get an answer as to make and model of CT machines used for my survelliance.
Dissappointed and a little disgusted at the moment. Its like when you put your blinker on in advance to let everyone know you need to change lanes it throws everything off and everyone behind you wrecks.
8/19 RC CEA 82.6 T3N0M0
Neoadj 5FU/rad 6 wk
High dose IVC 1 1/2 wks before surgery. Continue still twice a week
Surg 1/20 APR - margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24/post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
7/20 CEA 11.1, 8.8
8/20 CEA 7.8
9/20 CEA 8.8, 9, 8.6
10/20 CEA 8.1
11/20 CEA 8's
12/20 CEA 8's & 9's
ADAPT+++ TM drug
MHL1+
PMS2+
MSH2+
MSH6+
POLD1 , KRAS Q61H
Chem-sens test NCI "Test failed, neo adj CR worked. Not enough ca cells to test"

stu
Posts: 1505
Joined: Sat Aug 17, 2013 5:46 pm

Re: Better scans maybe

Postby stu » Wed Jun 16, 2021 6:47 am

Sorry you are not getting the cooperation you need!

It has been amazing watching the changes to scans in the last decade . When my mum first started out in 2009 they could only detect 5mm and above , laterally they watch a met in her lung grow from 2 mm.
Not sure how sensitive you require but I would have thought the age and specifics of the equipment would be quite easy to determine at least from the manufacturer! They might be better to approach!
take care ,
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

User avatar
beach sunrise
Posts: 502
Joined: Thu Mar 05, 2020 7:14 pm

Re: Better scans maybe

Postby beach sunrise » Wed Jun 16, 2021 8:40 am

Hi Stu, I agree.
I called a few BIG hospitals to check on their high tech scan machines. Cleveland Clinic told me the one I asked about was only FDA approved for lung cancer. WTH! Down the road it might be approved for CRC but no idea to when.
Another place I called about an even better machine said it is only approved for brain and knees at this time. Again, knees??? WTH! She put me on the list for research if it becomes available.
Just disgusted really now that I know better machines are out there just can't get to them. Might have to go overseas where they are using them for CRC.
What a racket big pharma, insurance and FDA have here in the states.
8/19 RC CEA 82.6 T3N0M0
Neoadj 5FU/rad 6 wk
High dose IVC 1 1/2 wks before surgery. Continue still twice a week
Surg 1/20 APR - margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24/post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
7/20 CEA 11.1, 8.8
8/20 CEA 7.8
9/20 CEA 8.8, 9, 8.6
10/20 CEA 8.1
11/20 CEA 8's
12/20 CEA 8's & 9's
ADAPT+++ TM drug
MHL1+
PMS2+
MSH2+
MSH6+
POLD1 , KRAS Q61H
Chem-sens test NCI "Test failed, neo adj CR worked. Not enough ca cells to test"

stu
Posts: 1505
Joined: Sat Aug 17, 2013 5:46 pm

Re: Better scans maybe

Postby stu » Wed Jun 16, 2021 11:09 am

I had not realised that ! We are currently raising money from a top MRi for our cancer unit but it has never been suggested that it is only used by certain areas of the body or primaries ! I must ask some questions and find out it that is common or general practice.
I shall update you!
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

User avatar
beach sunrise
Posts: 502
Joined: Thu Mar 05, 2020 7:14 pm

Re: Better scans maybe

Postby beach sunrise » Wed Jun 16, 2021 11:35 am

Yes, ask. Important to know this info for sure.
8/19 RC CEA 82.6 T3N0M0
Neoadj 5FU/rad 6 wk
High dose IVC 1 1/2 wks before surgery. Continue still twice a week
Surg 1/20 APR - margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24/post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
7/20 CEA 11.1, 8.8
8/20 CEA 7.8
9/20 CEA 8.8, 9, 8.6
10/20 CEA 8.1
11/20 CEA 8's
12/20 CEA 8's & 9's
ADAPT+++ TM drug
MHL1+
PMS2+
MSH2+
MSH6+
POLD1 , KRAS Q61H
Chem-sens test NCI "Test failed, neo adj CR worked. Not enough ca cells to test"

stu
Posts: 1505
Joined: Sat Aug 17, 2013 5:46 pm

Re: Better scans maybe

Postby stu » Wed Jun 16, 2021 5:00 pm

Just asked a consultant here and they have never heard of that . They just send them to be scheduled in . I thought so as my mum has had over 35 scans and it can be at any big hospital in the city that has a space .
We are under the NHS ! No insurance but I can’t see the private hospitals having a different system either !
Might not help your own situation right enough but may provide some insight .
Take care ,
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

rp1954
Posts: 1561
Joined: Mon Jun 13, 2011 1:13 am

Re: Better scans maybe

Postby rp1954 » Wed Jun 16, 2021 11:34 pm

"top" MRI - is that a 7T, 9T or 10.5T magnet?

A lot of the problem has to do with insurances as well as FDA.
Liability for the dr; payment affects both dr and patient.

A lot of stuff can be better overseas with less interference, but caveat emptor.
watchful, active researcher and caregiver for stage IVb/c CC. surgeries 4/10 sigmoid etc & 5/11 para-aortic LN cluster; 8 yrs immuno-Chemo for mCRC; now no chemo
most of 2010 Life Extension recommendations and possibilities + more, some (much) higher, peaking ~2011-12, taper to almost nothing mid 2018, mostly IV C

stu
Posts: 1505
Joined: Sat Aug 17, 2013 5:46 pm

Re: Better scans maybe

Postby stu » Thu Jun 17, 2021 4:19 am

Long time no see rp1954.
Hope you are all well ,
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

User avatar
beach sunrise
Posts: 502
Joined: Thu Mar 05, 2020 7:14 pm

Re: Better scans maybe

Postby beach sunrise » Thu Jun 17, 2021 9:25 am

Stu, if you all are getting the 7T, 9T or 10.5T I am headed to Scotland for a scan :)
8/19 RC CEA 82.6 T3N0M0
Neoadj 5FU/rad 6 wk
High dose IVC 1 1/2 wks before surgery. Continue still twice a week
Surg 1/20 APR - margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24/post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
7/20 CEA 11.1, 8.8
8/20 CEA 7.8
9/20 CEA 8.8, 9, 8.6
10/20 CEA 8.1
11/20 CEA 8's
12/20 CEA 8's & 9's
ADAPT+++ TM drug
MHL1+
PMS2+
MSH2+
MSH6+
POLD1 , KRAS Q61H
Chem-sens test NCI "Test failed, neo adj CR worked. Not enough ca cells to test"

stu
Posts: 1505
Joined: Sat Aug 17, 2013 5:46 pm

Re: Better scans maybe

Postby stu » Thu Jun 17, 2021 11:44 am

We have a t7 MRI at our new hospital ! To be fair I think the rest of the country might not have them yet but we do and our cancer centre is fundraising for a more sophisticated one !
Other than that I think it’s in general use !
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

User avatar
Green Tea
Posts: 421
Joined: Mon Oct 24, 2016 10:48 am

Re: Better scans maybe

Postby Green Tea » Thu Jun 17, 2021 2:36 pm

beach sunrise wrote:Hi Stu, I agree. I called a few BIG hospitals to check on their high tech scan machines. Cleveland Clinic told me the one I asked about was only FDA approved for lung cancer. WTH! Down the road it might be approved for CRC but no idea to when.
Another place I called about an even better machine said it is only approved for brain and knees at this time. Again, knees??? WTH! She put me on the list for research if it becomes available.
Just disgusted really now that I know better machines are out there just can't get to them. Might have to go overseas where they are using them for CRC.
What a racket big pharma, insurance and FDA have here in the states.

I have the feeling that the CT scanner issue is a lot more complicated than we imagine. CT scanners are not just machines. They have both hardware and software components, and I think that for a given model of CT scanner both the hardware and software components can be configured to allow the same scanner to deal with different specific scan needs. And apparently in the U.S. both the hardware and software modules need to undergo FDA review and approval if the radiologists plan to use the AI components to help them quickly interpret scans.

For some of the machines, the AI software needed for certain applications (e.g., cardiac applications or lung applications) may already be available and approved by the FDA while applications in other areas for a given machine may still be under development or still under FDA review.

My cancer center uses Siemens "SOMATOM Definition AS" scanners for all sorts of cancer diagnoses and surveillance. It seems to be one of the most versatile scan machines around. Patients spend on average around 15 minutes in the scan prep room while the scan itself takes only about 5 minutes. After the scan is complete, the radiology report is prepared by a radiologist with the help of Siemens AI software and is sent electronically to the oncologist within about an hour. The patient then has a scheduled meeting on site with his/her oncologist about 2 hours after the scan took place in order to receive the results and interpretation. I had my bi-annual CT scan yesterday and everything, including meeting with my oncologist, was finished within three hours, and the whole process cost me a total of 68 Euros.

How Much Does a CT Scanner Cost?
    "Software and hardware features can also add a significant amount of money to the price tag, ranging from $35,000 to $100,000 for a cardiac software suite, or $15,000 to $35,000 for the lung application. That’s why it’s important to be well aware of your clinical requirements in the type of studies your facility will perform before making a decision about which to acquire."
https://www.excedr.com/blog/ct-scanner-cost/

Full body CT scans - What you need to know
https://www.fda.gov/radiation-emitting-products/medical-x-ray-imaging/full-body-ct-scans-what-you-need-know
Last edited by Green Tea on Tue Jun 22, 2021 7:17 am, edited 1 time in total.

User avatar
beach sunrise
Posts: 502
Joined: Thu Mar 05, 2020 7:14 pm

Re: Better scans maybe

Postby beach sunrise » Thu Jun 17, 2021 3:57 pm

Stu, does it image the abdomen? In the USA the 7T is missing the middle coil for the application because it is not approved for it yet. BUT, overseas it is. SMH
8/19 RC CEA 82.6 T3N0M0
Neoadj 5FU/rad 6 wk
High dose IVC 1 1/2 wks before surgery. Continue still twice a week
Surg 1/20 APR - margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24/post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
7/20 CEA 11.1, 8.8
8/20 CEA 7.8
9/20 CEA 8.8, 9, 8.6
10/20 CEA 8.1
11/20 CEA 8's
12/20 CEA 8's & 9's
ADAPT+++ TM drug
MHL1+
PMS2+
MSH2+
MSH6+
POLD1 , KRAS Q61H
Chem-sens test NCI "Test failed, neo adj CR worked. Not enough ca cells to test"

stu
Posts: 1505
Joined: Sat Aug 17, 2013 5:46 pm

Re: Better scans maybe

Postby stu » Sat Jun 19, 2021 3:15 am

I seem to be running aground with finding information! It seems it’s a research MRI and has some clinical use but it does not specify what ! The one at cancer centre is only £100000 away from being funded and hopes to do more but again they don’t give away to many details . I will need to find out more .

The more you dig the more complex it becomes !
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

rp1954
Posts: 1561
Joined: Mon Jun 13, 2011 1:13 am

Re: Better scans maybe

Postby rp1954 » Sat Jun 19, 2021 5:05 am

stu wrote:I seem to be running aground with finding information! It seems it’s a research MRI and has some clinical use but it does not specify what ! The one at cancer centre is only £100000 away from being funded and hopes to do more but again they don’t give away to many details . I will need to find out more . The more you dig the more complex it becomes !

Now's the time to get or extort some good answers.
Once they have spent your money, they can get more proprietary and less responsive.
watchful, active researcher and caregiver for stage IVb/c CC. surgeries 4/10 sigmoid etc & 5/11 para-aortic LN cluster; 8 yrs immuno-Chemo for mCRC; now no chemo
most of 2010 Life Extension recommendations and possibilities + more, some (much) higher, peaking ~2011-12, taper to almost nothing mid 2018, mostly IV C

User avatar
beach sunrise
Posts: 502
Joined: Thu Mar 05, 2020 7:14 pm

Re: Better scans maybe

Postby beach sunrise » Sat Jun 19, 2021 12:37 pm

Maybe if you told them you were going to slow down/with hold purchase indefinitely until you get all the answers of what imaging capabilities it will have, body/cancers scanned fresh off the truck and in the facility, they might be more willing to give up exactly the technology you are purchasing.
I was told from Cleveland Clinic the Third Generation DECT is only used for lung cancer. It is used for other things not related to cancer but for cancer scanning, lung cancer is it. I told her about research and overseas scanning CRC patients. Reply was "if it was proven we would be doing it." I don't know if she meant FDA is in the way or they don't recognize overseas capabilities to implement on their own (hey, lets try this and see).
The T7 apparently is only used for brain and knees at the moment (missing the middle coil per FDA)...sounds like a bunch of country club old men got a fundraiser together to buy one of the best to keep check on their dementia and gout. Not being funny, but nothing surprises me. Idk!
8/19 RC CEA 82.6 T3N0M0
Neoadj 5FU/rad 6 wk
High dose IVC 1 1/2 wks before surgery. Continue still twice a week
Surg 1/20 APR - margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24/post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
7/20 CEA 11.1, 8.8
8/20 CEA 7.8
9/20 CEA 8.8, 9, 8.6
10/20 CEA 8.1
11/20 CEA 8's
12/20 CEA 8's & 9's
ADAPT+++ TM drug
MHL1+
PMS2+
MSH2+
MSH6+
POLD1 , KRAS Q61H
Chem-sens test NCI "Test failed, neo adj CR worked. Not enough ca cells to test"


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