3.0 Tesla MRI for imaging prostate

[THAIJAMES]

I live in Chiangmai and before getting a biopsy I would like to get an MRI of my prostate.

 

I understand that Siriraj, Chulalongkhorn, and Bangkok General  hospital might have the 3.0 Tesla MRI, which is very detailed and can identify cancerous legions if any.

 

Does anyone have experience with getting an MRI with this scanner for their prostate?

if so I would really appreciate some feedback:

 

1. What is the hospital that you had the 3.0 Tesla MRI scan and approximate cost of the MRI and does that include the cost of the radiologist or specialist review.

 

2.  Would I be able to fly in from Chiang Mai get an MRI and be able to take back the results and CD back to Chiang Mai the same day?.

 

3.  Do I need to ask for a specific type of MRI test or would just mentioning a prostate MRI be enough

 

4.  What are you thoughts on the MRI?

 

Thank you in advance.

 

Edited June 27, 2019 by THAIJAMES

[oxysong]

If they do not Id pick Bombay,or Chennai,about 3 to 4 thousand baht,same as normal MRI,    Calcutta 2 hours from BKK  4/ 5 000 return  may have a few machines,you may have to go to medifee.com and skype individual centres

[stubuzz]

Take a look here

[CMoldie]

2 hours ago, THAIJAMES said:

2.  Would I be able to fly in from Chiang Mai get an MRI and be able to take back the results and CD back to Chiang Mai the same day?.

Be careful with this. Yes, you probably can get the images on a CD the same day but they are not much use if your doctor in Chiang Mai has no experience of screening these high resolution images. The scan is only as good as the specialist who screens it. I speak from experience here.

If I had my time over again for the scan I had done in Bangkok, I would have a consultation at the hospital in question and have the results evaluated by a specialist in that hospital who was familiar with that type of scan, then wait to get the results and evaluation together or have them put on a CD and sent to me by EMS.

[THAIJAMES]

58 minutes ago, CMoldie said:

Be careful with this. Yes, you probably can get the images on a CD the same day but they are not much use if your doctor in Chiang Mai has no experience of screening these high resolution images. The scan is only as good as the specialist who screens it. I speak from experience here.

If I had my time over again for the scan I had done in Bangkok, I would have a consultation at the hospital in question and have the results evaluated by a specialist in that hospital who was familiar with that type of scan, then wait to get the results and evaluation together or have them put on a CD and sent to me by EMS.

Thank you that is very valuable advice

[elektrified]

I can answer this one - " 3.  Do I need to ask for a specific type of MRI test or would just mentioning a prostate MRI be enough"

 

Although they would know exactly what you want, you could ask for "multi-parametric prostate MRI with contrast". I believe that is the only prostate MRI they do. They will check your BUN and Creatinine the day before the MRI to make sure your kidneys can handle the Gadolinium dye that they inject into your vein 1/2 way through the scan.

[elektrified]

4 hours ago, CMoldie said:

Be careful with this. Yes, you probably can get the images on a CD the same day but they are not much use if your doctor in Chiang Mai has no experience of screening these high resolution images. The scan is only as good as the specialist who screens it. I speak from experience here.

If I had my time over again for the scan I had done in Bangkok, I would have a consultation at the hospital in question and have the results evaluated by a specialist in that hospital who was familiar with that type of scan, then wait to get the results and evaluation together or have them put on a CD and sent to me by EMS.

That is a very good point and I agree with this.

 

Also, urologists in Chiang Mai have an oddity that if an MRI is read by a radiologist in Bangkok that they don't know personally or have never heard of - they will not entertain the results in the report. When I brought my radiology report from the radiologist at Siriraj to my doctor in C.M., he would not even read it all the way through. He tossed it on his desk and said he had never heard of the other doctor and could not trust the interpretation of the MRI. When I went to the next urologist, his reaction was identical.

Edited June 27, 2019 by elektrified

[THAIJAMES]

7 hours ago, elektrified said:

That is a very good point and I agree with this.

 

Also, urologists in Chiang Mai have an oddity that if an MRI is read by a radiologist in Bangkok that they don't know personally or have never heard of - they will not entertain the results in the report. When I brought my radiology report from the radiologist at Siriraj to my doctor in C.M., he would not even read it all the way through. He tossed it on his desk and said he had never heard of the other doctor and could not trust the interpretation of the MRI. When I went to the next urologist, his reaction was identical.

You bring up a good point. besides having the specialist in Bangkok interpret the results would it also be beneficial to have your urologist in chiangmai recommend someone that could interpret the results here in Chiang Mai by looking at the images.

 

Or do you think it would be better to trust the results in Bangkok and if any biopsy or other procedure is required just do that at a Bangkok Hospital.

Edited June 27, 2019 by THAIJAMES

[oxysong]

Whatever you do in Thailand,its going to cost a packet.identical situation in BKK hospital, after MRI,doctor missed cancer,flew to Delhi later MRI ..cancer found,too late

[Sheryl]

Please see these threads

 

https://forum.thaivisa.com/topic/899318-prostate-cancer-specialists-in-bangkok/

 

 

You will not be able to do this in a single day and, as others have explained, bringing back a CD to be read by a doctor in CM is not practical. reading multi-parametric MRI of the prostate is a highly specialized task.

 

Since the MRI reading  will determine whether a biopsy is indicated and, if indicated, guide where to sample it would make sense to have full consultation and biopsy done all at the same hospital in Bangkok. Once matters are clear and a course of treatment decided upon, depending ion what it is you can decide whether to have it done in CM, Bangkok or elsewhere. First step is to determine whether there is cancer and, if so, how aggressive and what stage.

 

Your options as best i know are Siriraj, Chulalongkorn and Samitivej Hospitals. Siriraj has a private wing which costs less than Samitivej but more than the public channel at either Siriraj or Chula but much quicker and expat-convenient than these latter. It is where I suggest you go. Book a nearby hotel and be prepared to spend about  a week.  Here is the link for booking appointment:

 

http://www.siphhospital.com/en/home

 

Ask for appt with Prof. Dr Sittiporn Srinualad

 

 

[elektrified]

5 hours ago, THAIJAMES said:

You bring up a good point. besides having the specialist in Bangkok interpret the results would it also be beneficial to have your urologist in chiangmai recommend someone that could interpret the results here in Chiang Mai by looking at the images.

 

Or do you think it would be better to trust the results in Bangkok and if any biopsy or other procedure is required just do that at a Bangkok Hospital.

If you are happy with your present urologist (or the one you are going to see for a 2nd opinion), then you should ask him/her for a recommendation of where to go in Bangkok for the Tesla 3.0 MRI scan and which radiologist to interpret it. I've found that the urologists here don't like to drift too far from their inner circle of colleagues. They have their favorite radiologists that they have worked with, done research with, and attended conferences together abroad. They know how accurate their interpretations of prostate MRI's are based on how many prostate MRI's of their patients they have interpreted. In the case of my first doctor, he was even picky about the technicians who actually perform the MRI procedure. Unfortunately, I missed his cue when he recommended Bangkok General and I found out later that the MRI staff who perform prostate MRI's there all used to work at Suan Dok together.

 

C.M. radiologists won't interpret MRI images performed outside of CMU. Why? My doctor told me that since the scans will have to have been analyzed and then signed off by a radiologist at the facility where it was performed, Thai radiologists consider it bad luck to interpret MRI images that another radiologist has already formed an opinion about. Strange? Yes. But TiT. Also, like Sheryl pointed out, there may not be a qualified radiologist here who is knowledgeable with Tesla 3.0 scans of the prostate.

 

Like Sheryl said above, it can't be done in one day. When I was calling around to get the details for the Tesla 3.0 MRI, I was told I would need to come to about 3 appointments over a week's time. Chula was the most difficult and inconvenient. As I recall, several appointments were necessary over a 3-4 week period. Not really practical if you live in C.M.

 

 

[THAIJAMES]

6 hours ago, oxysong said:

Whatever you do in Thailand,its going to cost a packet.identical situation in BKK hospital, after MRI,doctor missed cancer,flew to Delhi later MRI ..cancer found,too late

I very sorry to hear that.  Was it prostate cancer?

[THAIJAMES]

6 hours ago, Sheryl said:

http://www.siphhospital.com/en/home

 

 

Ask for appt with Prof. Dr Sittiporn Srinualad

Thank you for the helpful links and your very good Advice.

 

I called Siriraj hospital about the Tesla 3.0 MRI for prostate scan.  While they do have the Tesla 3.0 MRI, they informed me that they only use the Tesla 1.5 for for prostate MRI scans because it give a better image than the 3.0.

That's very confusing.

The price quoted was 15-18K (Chiang mai is 25K)

 

I asked about Dr Sittiporn Srinualad, they could not find his name in the database.

A google search shows him working at Bumrungrad and Mahidol.

 

I called Samitivej Hospital and they do use the Tesla 3.0 MRI for a prostate scan with color contrast.

 

The cost is 19K for the MRI plus 7000 for the color contrast.  This includes the cost of the radiologist giving results.  But I would need a doctors orders to get a scan.

 

They gave me the impression that I could just take the radiologist results and CD back to Chiangmai and my urologist could explain the findings.

Edited June 28, 2019 by THAIJAMES

[oxysong]

1 hour ago, THAIJAMES said:

I very sorry to hear that.  Was it prostate cancer?

Yes.  but here is a point,(think Ill copy and re post this bit)  whilst there get every scan procedure known to man done. bowel/stomach/skin/heart echo/heart stress test/eye cataract/hearing done too so professional it will melt you  100,000 here in thailand ,2000 there in India. Cheap to get there,farang friendly,no cooking pot awaiting

[Lumbini]

Get it at Bumrungrad then use the results to have fusion guided biopsy in the US total price will not be super cheap but if anything is missed and biopsy done that’s not fusion guided by MRI if it shows something and one just has traditional biopsy done while surgeon uses ultrasound much can be missed . Why take that risk especially if PSA has climbed over the years and is over 4 or 5 . I know little but the MRI done right and if needed fusion guided biopsy using that MRI as the map for the biopsy is big advancement . I know little but this information is almost mainstream now . Get the MRI at Bumrungrad then send results to the states so a well experienced surgeon who does fusion guided biopsy can advise . If you show the MRI to urologist here possibly their existence with MRI examination and fusion guided biopsy from mri is almost nothing .


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[Sheryl]

Thank you for the helpful links and your very good Advice.
 
I called Siriraj hospital about the Tesla 3.0 MRI for prostate scan.  While they do have the Tesla 3.0 MRI, they informed me that they only use the Tesla 1.5 for for prostate MRI scans because it give a better image than the 3.0.
That's very confusing.
The price quoted was 15-18K (Chiang mai is 25K)
 
I asked about Dr Sittiporn Srinualad, they could not find his name in the database.
A google search shows him working at Bumrungrad and Mahidol.
 
I called Samitivej Hospital and they do use the Tesla 3.0 MRI for a prostate scan with color contrast.
 
The cost is 19K for the MRI plus 7000 for the color contrast.  This includes the cost of the radiologist giving results.  But I would need a doctors orders to get a scan.
 
They gave me the impression that I could just take the radiologist results and CD back to Chiangmai and my urologist could explain the findings.

1. Dr. Sittiporn is at Siriraj. He is on the faculty there. He also does private practice at Bumrungrad etc but Siriraj is his main affiliation. Maybe they were checking a database of doctors who toutinely work in the orivate wing. Just tell them firmly that he is an acharn at Siriraj and they should be able to arrange an appointment. Others have done so.

2. As explaine oreviously, while hospitak can certainly give you a CD to take away, it cannit be used by your urologist in CM unless he us soecially trained in it which I much doubt.

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[THAIJAMES]

On 6/28/2019 at 5:32 PM, Lumbini said:

Get it at Bumrungrad then use the results to have fusion guided biopsy in the US total price will not be super cheap but if anything is missed and biopsy done that’s not fusion guided by MRI if it shows something and one just has traditional biopsy done while surgeon uses ultrasound much can be missed . Why take that risk especially if PSA has climbed over the years and is over 4 or 5 . I know little but the MRI done right and if needed fusion guided biopsy using that MRI as the map for the biopsy is big advancement . I know little but this information is almost mainstream now . Get the MRI at Bumrungrad then send results to the states so a well experienced surgeon who does fusion guided biopsy can advise . If you show the MRI to urologist here possibly their existence with MRI examination and fusion guided biopsy from mri is almost nothing .


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I'm going to the States in two or three months would it be just better to have it all done over there?

[THAIJAMES]

On 6/28/2019 at 5:44 PM, Sheryl said:

1. Dr. Sittiporn is at Siriraj. He is on the faculty there. He also does private practice at Bumrungrad etc but Siriraj is his main affiliation. Maybe they were checking a database of doctors who toutinely work in the orivate wing. Just tell them firmly that he is an acharn at Siriraj and they should be able to arrange an appointment. Others have done so.

2. As explaine oreviously, while hospitak can certainly give you a CD to take away, it cannit be used by your urologist in CM unless he us soecially trained in it which I much doubt.

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I agree that my urologist would not be able to do anything with it, for example a guided biopsy.

 

but I'm assuming that the results are written by the radiologist and the doctor explains the results to me.

 

Of course if there is cancer then I would not do anything in chiang Mai. I would either fly back to Bangkok or USA.

 

Flights to Bangkok are cheap

it doesn't make sense to wait around.

 

also talking to the staff there they said it was pretty easy to have the MRI on the same day and have the doctor review the results.

Edited June 30, 2019 by THAIJAMES

[Sheryl]

I'm going to the States in two or three months would it be just better to have it all done over there?

Yes if you will be there long enough



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[THAIJAMES]

1 hour ago, Sheryl said:

Yes if you will be there long enough



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I will look into it I will be there for about 3 weeks I could stay longer if required.

Right now I'm just trying to avoid having a biopsy and trying to get an MRI first to see if I need a biopsy.

[oxysong]

41 minutes ago, THAIJAMES said:

I will look into it I will be there for about 3 weeks I could stay longer if required.

Right now I'm just trying to avoid having a biopsy and trying to get an MRI first to see if I need a biopsy.

Must weigh heavy the not knowing, probably in the same boat as you if I

live long enough.  

  if you have a day or so off just go to Delhi,counted 14 at least 3t machines,some with wide bore,cheap about 3 to 4 thousand Rps.  When I have MRIs done there always a resident doctor to interpret results,fact is the machine picks up and highlights the problem.   AS a foreigner they probably will attempt to jack up the price,just do a walk in with printed price off the net 

 

if biopsy needed,more than probably there and then

Edited July 1, 2019 by oxysong

[sclark]

I have a lot of experience in the US with prostate cancer and mp MRI's (multi parametric MRI for prostate).  Bumrungrad now has 3Tesla mp MRI, 52,000 baht.  It is a real mp MRI scan, and includes the injection from IV at the end, and lasts about 1 hr. 15 min.  They used to have 1.5 Tesla with endorectal core, but got a 3 Tesla a couple of years ago.  It is noted that at UCLA and MD Anderson, and others in the US: they require an enema beforehand.  This is in case they see tumors, they can take a needle biopsy, guided by MRI, and it has to go through your rear end, so they require an enema.  At Chula, no enema needed, so that means they do not do the follow-up as required with needle biopsy to prove it right.  I understand that Chulabhorn Hospital also has a 3 Tesla mp MRI but haven't confirmed it.  

 

[sclark]

Also:  What is your PSA, by the way?  That is why you think you need a scan (needle biopsy or mp MRI), right?  Don't waste your time with a needle biopsy...that's ancient.  mpMRI is highly accurate.  Also needle biopsies were prone to 1% patients who got an infection, in which case it's very nasty.  Keep in mind the 52k price at Bumrungrad.  My urologist doctor at Bumrungrad, by the way, was...let's just say I will never go back to him.  We almost got into a shouting session.  Ha!  I really like the other doctors I have had at that hospital.  I was diagnosed with PCa 15 years ago, went 11 years of Active Surveillance, then had targeted cryo ablation.  I chose the wrong doctor there at Bumrungrad.  My mistake.  He had no fellowships at any American hospitals nor other reputable places (Germany, S Korea), like almost all the other doctors did.  Enough said.  Good luck.   

[THAIJAMES]

1 hour ago, sclark said:

Also:  What is your PSA, by the way?  That is why you think you need a scan (needle biopsy or mp MRI), right?  Don't waste your time with a needle biopsy...that's ancient.  mpMRI is highly accurate.  Also needle biopsies were prone to 1% patients who got an infection, in which case it's very nasty.  Keep in mind the 52k price at Bumrungrad.  My urologist doctor at Bumrungrad, by the way, was...let's just say I will never go back to him.  We almost got into a shouting session.  Ha!  I really like the other doctors I have had at that hospital.  I was diagnosed with PCa 15 years ago, went 11 years of Active Surveillance, then had targeted cryo ablation.  I chose the wrong doctor there at Bumrungrad.  My mistake.  He had no fellowships at any American hospitals nor other reputable places (Germany, S Korea), like almost all the other doctors did.  Enough said.  Good luck.   

Thank you for the very useful information.

My PSA level was 8.2 and my local doctor wanted to do a needle biopsy.

Luckily I refused basically because the size of my prostate was double the size of a regular prostate by volume.

Which would make it normal for the PSA level to be 8 or so. Also the fact that my dad had a similar trajectory at my age he now has a PSA of 13.

 

I ended up trying finisteride and after about three to four months my PSA level went down to around 4.

 

Note that I didn't take the regular dose of 5mg of finasteride instead I took .2 mg and still got the same good result.