Another Bit of Good Fortune: The Frugal MRI

I was a bit discouraged about the cost of having a new, high resolution prostate MRI.  $5000 is a lot of money, especially in the current economy where it could pay bills for a couple months, as layoffs are looming everywhere.  There had to be something similar and less expensive in the Chicago area.  With major universities like the University of Chicago, Northwestern, Loyola and the University of Illinois at Chicago, someone had to be doing it.  That’s not even including the dozens of private hospitals and clinics in the area and other nearby universities like Iowa, Purdue, Wisconsin and Illinois.  Still, I could find nothing on almost every kind of search I tried.

What I did find was research.  Names and email addresses of urologists, radiologists and others who were doing work in prostate imaging.  One of them might know someone else doing this kind of diagnostic for patients, maybe even in the Chicago area.  I also contacted some local people who came up on a search of seminars in the local area, some through a great organization called UsToo.  Still, nothing I could find anywhere in the midwest.  The major institutions doing this type of research seem to be in Boston, New York City, San Fransisco, Houston and Maryland.

I was intrigued by the response from a researcher in Maryland.  He referred me to his associate, a urologist.  I had a discussion with the urologist’s scheduler recently.  As a result, I now have an appointment to spend an extended weekend in Bethesda, Maryland.  From what I understand, it is a good fit for me.  On a Friday, I get a high resolution “3T” MRI scan, much the same as the one in Florida I mentioned in previous blogs.  By Monday, I will have the results.  If anything suspicious is found, I have a biopsy.

No, I haven’t changed my mind about the biopsy.  There are a couple differences here, though.  First, if they found something suspicious, it’s now a reasonable cause for me to have a biopsy and determine if it is cancer.  A reasonable cause that I haven’t had so far.  Second, they actually use the MRI results to guide the biopsy.  First they do a typical biopsy as they would have done with no prior information.  Then they take additional samples, targetted to the locations the MRI showed as being unusual.  I gather the accuracy isn’t great, but it’s certainly no worse than a regular biopsy that I would now need anyway.

Okay, okay, there’s a third thing.  It’s free.  Well, maybe not free.  I’m told travel is re-imbursed at a fixed rate, so I may not get back exactly what I spend.  On the other hand, since I have no family in the area and would otherwise need a hotel, the research grant also pays for a room in their clinic hospital.  From what I gather, the bulk of the cost is paid by you, the taxpayer.  The National Institutes of Health are federally operated and apparently the costs for research projects are paid by the government.  Sometimes, you have to hand it to the government.  Not only are they allowing me to get a procedure I may not have been able to afford, but they are spending their money on worthy research that may someday reduce the number of unnecessary prostate biopsies!

The 3T MRI and followup in Florida is still appealing.  The main problem is cost, most of which would probably not be reimbursed by my particular insurance plan.  Plus, I’ve already spent $950 on an ultrasound that now seems at least a little questionable.  I’m still waiting to hear back from some of the other institutions that do this type of imaging, but as of now, I plan to be in Washington D.C. in late February.  There seems to be a lot of clout there from Illinois, now.  Maybe I can get a tour!

I pray my good fortune holds for another month or two.

14 thoughts on “Another Bit of Good Fortune: The Frugal MRI”

  1. I would like the MRI but my doctor says with my heart stent they can’t because my stent can only handle 1.5 to 3 telsa…whatever that means.

    His machine is over 3 telsa. Is ther a lower rated machine somewhere?

  2. Hello,
    What was the outcome of your 3T-MRI? Are you still working with National Institute for Health. Are they still offering a 3T-MRI prior to a prostate cancer diagnosis? I looked at the clinical trials at their site and it appears that you have to already be diagnosed?
    Thanks,
    Wes

    1. In my case, I was not diagnosed with PC, only with an abnormally high PSA and enlarged prostate. If you read the rest of this blog, especially the entries from Feb 27 to March 12th, 2009, you will find all the details on my visit to NIH. They did suggest I could return for a repeat procedure if my PSA continued to climb or if I had other symptoms, but so far I have not.

  3. Thats the question? An MRI with spectroscopy using a 3T (tesla) scan focuses down giving a .5cm or greater tumor accuracy (some say < .5 cm ). So where can I now get a second opinion with a MRI/spectroscopy 3T with an MRI guided biopsy if needed? My local urologist says My DRE is 1.5 cm x
    1.2 cm at the apex and wants to a TRUS Biopsy. ALso I've had a PCA3 urine giving a negative score.
    The radiologist says the apex area is not that big ( 1.5 x 1.2 cm ). I don't think a random biopsy is the way to go. Tecnology exists for MRI guided biopsy. I don' want to make my prostate a pin cushion with all the risk…

    1. Hi Dave, they seem to be more common now. I’d guess some of the major university medical centers would have one. Whether they are used for prostate screening or research is another question.

  4. I have been trying to do exaclty what you have, apparently, accomplished.
    My problem is that my urologist does not believe in the 3T MRI. He believes it is a waist of time and money. He is looking forward to turn my prostate in to a pin cushon.
    I, obviously do not agree with him and this is why I am looking at the 3TMRI with the coil. My concern is, is it accurate enough, assuming it does not show anything. Now what!. Am I clean from cancer? or do I resort to the Pin cushin test. The bottom line is can we trust the finding of the 3T MRI ???

    Thanks for your input.

    Ed Frymer

    1. Hi Ed, I would consider the 3T MRI essentially experimental for diagnosing early prostate cancer. If you pay out of your own pocket for one, it could well be a waste of time and money. I suspect a 3T MRI is probably sensitive enough to find a large, advanced tumor, but a biopsy would likely discover that as well. It’s the small, localized early cancers that either one can miss. In the case of the NIH study, you not only get the MRI, but if there is a finding, it can help target the biopsy to reduce the chance that the biopsy will result in a false negative. Really, my participation in the NIH study was in part to advance the state of the art, so that some day maybe an MRI or a combination MRI/biopsy will be a better diagnostic than a traditional biopsy alone. Plus, it was free, so the only real potential waste is time and it will cost you at least a few days unless you live in the Washington DC area.

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