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How to avoid a biopsy to test for prostate cancer


R123

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If you are considering MRI, keep in mind that Bumrungrad does not have the more modern and powerful 3T MRI. They are still using the older 1.5T MRI with endorectal coil. There are significant improvements with the imaging obtained from 3T MRI, and less chance of missing small tumours, as compared to 1.5T MRI. 

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As many know I have had , and maybe still have both prostate and colorectal cancer, I am unqualified in medical matters, but have a very serious amount of first hand experience, including cancers being missed in the early days, for which I was financially compensated, without protracted legal cases, by some very honest and loving doctors, ( I do not comment on their competence) out side Bangkok

 

I have had some of the best available treatment at Chulalongkorn Government Hospital, BKK who have probably the best equipment in Thailand at very affordable costs (maybe not for some but fortunately for me, as I am self insured)

 

I can not comment on the exact equipment they have but a lot is under two years old, and they are building a multi billion bhatt new facility at this moment, 2/3 yrs to completion

They even do live MRI s when administering very targeted radiation, it is all very fascinating and extremely high tech

 

Over the last couple of years I have had at least 4 MRI s 2 CAT scans, 5 colonoscopies,  various biopsies, numerous ultrasounds, and much much more, including Holep surgery in India With MRIs and CT scans in India as well

 

I notice HM the Queen goes there for imaging when required, again adding credence to my belief it is the top in Thailand

 

I would suggest anyone requiring imaging or cancer treatment explore this avenue, it has to be the best equipped hospital in Thailand, one of my doctors trained at the John Hopkins in USA

 

 I have had chemotherapy and radiology there, I believe and hope, I may be in remission, there are no guarantees, but today I feel very reasonable

 

I am scheduled for follow up appointments with four doctors in middle may, and  will be at Chulalongkorn for about a week,( we are staying at the Dusit Thani across the road, their discount of 65% was too good not to take !  !!   !!! , and also turn this into a mini break as well)  at that stage I  am being given internal ultrasound examination, and full chest xrays as well, plus much more

 

I keep my fingers crossed, and pray and say thank you, that all will continue to be quiet, when I go in May 

 

I will always help those who have a problem and willingly give my tel no to those who PM me

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al007 thank you for your comments , I have been using Chula for years and find it quite amazing also . I will keep you in my prayers and you are and inspiration to be so positive when facing so much thanks [emoji120]

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Very nicely written, al007. Like Lumbini said, your strong, positive attitude and your words are an inspiration for anyone on the difficult journey that you are on. Keep strong and my fingers are crossed for you too. Hopefully you will be getting some great news in May.

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Chennai hospital installs new MRI system that can reduce scan time by upto 67%

Saturday, August 13, 2016

by IMT News Desk

Chennai: Global Hospitals on Saturday inaugurated the country’s first wide-bore 3T Silent Scan MRI with MAGiC, which can reportedly reduce scan time by as much as 67%, at its hospital in Perumbakkam, Chennai. The hospital also inaugurated GE Healthcare’s Discovery IQ PET/CT system that can assist in diagnosis, staging and post treatment monitoring of cancer.

GE Healthcare’s Signa Pioneer, India’s first wide-bore 3T Silent Scan MRI with MAGiC that was inaugurated at Global Health City, Chennai on August 13, 2016.

GE Healthcare’s Signa Pioneer, India’s first wide-bore 3T Silent Scan MRI with MAGiC that was inaugurated at Global Health City, Chennai on August 13, 2016.

MRI scans are among the most advanced tools available to image a host of medical conditions that assist the clinician in their diagnosis. However, when people undergoing the MRI scans are questioned, the excessive noise and the duration they have to spend in the machine are reported as two of their biggest concerns areas. GE Healthcare’s Signa Pioneer MRI system aims to address these two concerns, according to a statement.

A conventional MRI scanner produces noise of about 110 decibels (dBA), rivalling noises from a steel mill, an aircraft engine or heavy traffic on roads. This loud noise causes patient discomfort and distress, which may affect the quality of scan outcome. GE Healthcare addresses this issue with the help of wide-bore Silent Scan technology. This enables a less stressful scanning experience. The noise level produced due to Silent Scan is as low as three decibels above ambient noise level (74 dBA). The Silent Scan technology was co-developed in India.

The magnetic resonance image compilation (MAGiC) technology, which has been introduced for the first time in India, helps in reducing scanning time by as much as 67%. Due to this technology a person can undergo a scan in about 5 minutes compared to the traditional 16-20 minutes.

MAGiC technology allows capture of multiple image contrast of a body part through a single scan, instead of one scan for each contrast, thereby significantly reducing the time for scan. MAGiC also gives doctors the flexibility to retrospectively change the contrast even after the scan is completed and the patient is discharged, thus saving the need of re-scan should there be such a requirement from the doctor.

“We are delighted to partner with a leading healthcare provider like Global Hospitals to bring these latest technologies for the benefit of people in Chennai,” said Milan Rao, President and CEO, GE Healthcare, India and South Asia.

MR Elastography in Signa Pioneer is designed to enable physicians to evaluate relative liver and muscle tissue stiffness, which help them make an assessment of tissue health before clinical symptoms become visible. MRE is fast emerging as a reliable alternative to invasive tissue biopsies, with reduced cost, pain and faster results. MRE cost significantly less, is non-invasive and can give results within 30 minutes compared to 72 hours for biopsies, the statement said.

Molecular imaging using Positron Emission Tomography–Computed Tomography (PET/CT), with its capabilities to combine anatomical and functional aspects of the body to provide a complete picture of patient’s health, is considered as a decisive tool for diagnosis, treatment staging as well as monitoring the progress of treatment, while also reducing overall treatment cost.

Healthcare providers not only want the ability to detect smaller lesions, but also the ability to accurately determine whether the patient is responding to current treatment. When using CT alone, up to six cycles of chemotherapy may be required to determine if the treatment is effective. PET/CT can help speed up treatment, because metabolic changes in a tumour occur more frequently than structural changes. It is a more accurate and reliable solution that can help clinicians determine how well a treatment is working after as few as 1 to 2 cycles of chemotherapy, and they will be able to tailor the treatment according to individual patient’s response and needs, according to the statement.

India accounts for 8% of the world’s cancer prevalence (about 3 million) with over 1 million new cases reported every year and more than 500,000 deaths every year from this condition. Breast cancer is the fastest growing in terms of incidence for women and kills the most. Prostate cancer is the fastest growing in terms of incidence for men, while lung cancer kills the most men. 

 

like everything at these private hospitals in Thailand,they cost one hell of a lot. If  cancer was detected during holep there in india  I had  personally I would have headed back there for treatment,(Chennai  more than likely), get a few quotes, as they will be contracting out to various local hospitals, just google

 

  Another poster on here a while ago commentated he went to a west coast  India urology hospital  (J Stone) I think,and stated it was good, better equipped etc.

 
 
     
     
 
 
 

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Chennai hospital installs new MRI system that can reduce scan time by upto 67%



 
     
 

 

 
     
     
 
 
 
 
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Chennai hospital installs new MRI system that can reduce scan time by upto 67% _ India Medical Times.htm

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Just noticed this thread which I started is active again.

I have re-read my written report about the "MRI of Prostate Gland".

Without going into any specific detail the finding for me was an enlarged prostate.

The MRI concluded:

"no evidence to suggest malignancy in the prostate gland".
Based on that finding my consultant (Dr Viroj) concluded a biopsy not necessary in my case.

I continue to have PSA tests regularly and whilst my readings are above average my doctor says no cause for concern.

 

-Of course whether MRI scan or biopsy or whatever no one can guarantee any test is 100% accurate in the same way as no one can guarantee  100% any of us will wake up tomorrow morning.

 

 

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Some kind comments, very much appreciated

 

INDIA VS THAILAND having experienced both

 

My observations are as follows

 

I had advanced Holep surgery in India at very affordable cost with technology not then available in Thailand, under USA trained surgeons

 

I expected this to be a one off with little need for follow up, and when my cancers were discovered in India the next step was very traumatic, I had no wish to remain in India for a year plus

 

On my Cancers  I can only say Chulalongkorn in BKK was both some of the best available in the world with very affordable costs, and I am uninsured in no way did it fit into the category like everything at these private hospitals in Thailand,they cost one hell of a lot.

 

I am very happy to be having the follow up done in Bangkok, ( for me one hour flying) where I am likely to have to go for checks every three months for two or three years, and then annually, we also like bangkok and it has some very enjoyable hotels that can with watching come at very affordable costs

 

Also if matters deteriorated I have an excellent team at the Chulalongkorn who know me and will do whatever is necessary, including top surgery

 

I would not want to be doing flights to India every three months then having surgery that might or might not be OK, for my wife BKK is so much better and easier

I would not want to become terminally ill in India, and who knows how long that might last

 

We have a plan on how to deal with long term terminal illness should that happen, at home in KhonKaen

 

When deciding on India or Thailand it is far more complex than just the operation alone

 

My preference will always be Thailand, also the nurses are prettier here, more caring and without a doubt the very best in the world, and to die in their smiling and loving care would be very OK

 

I hope to live a full life but there are no guarantees, and we need a plan just in case

 

 

 

 

R123 LAST POST

 

Whilst writing this post I note R123 has posted, and I comment my first MRI specifically for prostate gave the same written opinion, when that MRI was again looked at by Chula some 16 mths later they came to the conclusion, the person writing the report was mistaken, and my urologist at the time read the reports did not review the detailed MRI and smiled and said no problem, I was happy and did not challenge because it was the answer I wanted

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"R123 LAST POST

 

Whilst writing this post I note R123 has posted, and I comment my first MRI specifically for prostate gave the same written opinion, when that MRI was again looked at by Chula some 16 mths later they came to the conclusion, the person writing the report was mistaken, and my urologist at the time read the reports did not review the detailed MRI and smiled and said no problem, I was happy and did not challenge because it was the answer I wanted"

 

Impossible for you to say that you were given the same written opinion as me as you have not seen my report.

So the person writing your report made a wrong diagnosis or what?

Then you say your urologist did not review the detailed MRI properly...?

-You are making some extremely serious allegations here including medical negligence et al and remarkably against 2 specialists at the same facility.

 

Tell us what steps you have taken against these miscreants?

 

At the end of the day we must rely upon the expertise of consultants though I agree getting a 2nd or even 3rd opinions is always advisable.

And that is what I have done.

 

 

In your case you appear unfortunately to be the victim of more than one type of cancer.....

 

 

 

 

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OK folks,let's cool down,we are all here, to hopefully help each other.

 

It would seem that rather than jumping in blind,and having a biopsy, it is better to firstly have a mpMRI. Our problem here in Thailand is to find a hospital that can carry out the test,with modern equipment, and equally with trained and competent staff.

Bangkok Hospital, I believe possess the 3t MRI, yet still go straight to biopsy, maybe they do not have the mp procedure, or qualified staff to interperate the results. I honestly do not know.

 Bumrangrad are still using the older 1.5t with endorectal coil. 

 Samitivej Hospital,do according to "bubba" have the later 3t machine. Does anyone know, if they carry out the mp test.

That leaves Chula.  Which is highly praised by A1007. Where he says that he had an MRI. Perhaps he can tell us if their machine is the more modern 3t and there fore able to produce a more accurate image. And did his test incorporate the multi parametric Procedure.

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7 minutes ago, nontabury said:

OK folks,let's cool down,we are all here, to hopefully help each other.

 

It would seem that rather than jumping in blind,and having a biopsy, it is better to firstly have a mpMRI. Our problem here in Thailand is to find a hospital that can carry out the test,with modern equipment, and equally with trained and competent staff.

Bangkok Hospital, I believe possess the 3t MRI, yet still go straight to biopsy, maybe they do not have the mp procedure, or qualified staff to interperate the results. I honestly do not know.

 Bumrangrad are still using the older 1.5t with endorectal coil. 

 Samitivej Hospital,do according to "bubba" have the later 3t machine. Does anyone know, if they carry out the mp test.

That leaves Chula.  Which is highly praised by A1007. Where he says that he had an MRI. Perhaps he can tell us if their machine is the more modern 3t and there fore able to produce a more accurate image. And did his test incorporate the multi parametric Procedure.

OK folks,let's cool down,we are all here, to hopefully help each other. ABSOLUTELY AGREE ! !! !!!

 

Gentlemen you are above my level of competence

 

I believe Chula to be very well equipped with state of the art equipment

 

I do not speak thai but surely someone who does can make a simple phone call and enquire, if they have this most upto date equipment it is pretty certain they are going to be the most competitively priced, on several large ticket procedures Bangkok Hospital were three times more expensive than Chulalongkorn

 

Yes I am a big fan of Chulalongkorn, they have done wonderful things for me

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From Siemens thailand site 2013

 

https://www.siemens.co.th/iportal/aboutus/profile/

 

 

  • Chulalongkorn Memorial hospital has enhanced the quality of patient services and efficiency with the new Cathlab, AXIOM Artis Zee Biplane and 3T MR, MAGNETOM Skyra.

 

Is this what we are talking about, four years ago at Chula ! ! !          

 

I am not qualified to know

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2 posts with nothing but personal bickering have been removed.

 

I would like to clarify, because I think it may not have been clear in his post, that the wrong diagnoses referred to by AL1007 did not occur at Chula, but rather elsewhere, prior to his ever having gone to Chula.

 

Re th4 MRI machine I do not know for sure if the machine described can do mpMRI but I rather think not.

 

I do think that people tend to put excessive emphasis on the latest machine/technology when any technology is only as good as the skill and experience of the person using it. And in the case of deciding whether to do a prostate biopsy, no one single thing can decide it, even where mpMRI is available and the doctor skilled in it, it will not be the sole consideration but rather one more (very useful) bit of information.

 

It is  a complex matter and one that contains some element of risk whatever is decided, and part of the problem is that doctors are worried about being blamed, and tend to fear the consequences of missing a cancer more than the consequences of adverse effects from an unnecessary biopsy -- and they are not wrong in thinking that patients are more surely going to blame them for the former than the latter, especially since those not well read on the topic (which frankly includes almost all Thai patients) would not even  be aware that there is an issue about the need for biopsy when PSA is elevated etc,  whereas  everyone can understand the idea of a cancer diagnosis being missed.  The solution of course is for it to be an informed joint decision between doctor and patient, but few Thai doctors can even imagine let alone implement that.

 

It takes some courage to recommend against a biopsy plus a belief that the patient understands the situation,  is competent to make a decision, and can be relied upon to show up for periodic follow up appointments (very important).   IMO these are what is most often lacking and especially so in Thailand. It is nice to have additional data to back it up but even armed with no more than PSA results (including trend over time), DRE findings, and knowledge of the patient's age and overall health status, there are plenty of instances where doctors know that it would be medically justifiable to hold off for a while and just watch what the PSA does over time before going into biopsy, but do not , for the reasons just explained -- fear of blame, lack of confidence that the patient is capable of understanding and participating in the decision, lack of confidence that the patient will come back etc. etc.

 

Personally I would value those skills/traits and years of experience treating patients with suspected cancer and seeing which ones ultimately proved to have it (and there is such a thing as a "sixth sense" that very experienced doctors develop that can't always be explained solely based on quantifiable data at hand), along with sheer conscientiousness, over anything else.

 

If you have a choice between 2 doctors both with all of those skills at equal level,  and one has access to mpMRI and the other not, of course choose the former. But make these physician specific factors your main criteria rather than  the machinery available, IMO.

 

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Just another note regarding mpMRI:

 

MRI is not only used to help formulate an informed decision regarding a biopsy. If MRI does detect a lesion, then this is used together with endorectal ultrasound to form a fusion image, thus providing much more accurate targeting for the biopsy cores. With a negative DRE and ultrasound image, but without MRI imaging, the urologist is more or less "shooting in the dark" (to make a bad pun) and could completely miss a small but potentially high grade tumour. 

 

While I value an experienced urologist, I also highly value the accessibility of the best tools. Lacking one or the other can lead to a less than optimal outcome. Regardless of the experience and skill level of a urologist, I would never consent to a biopsy without mpMRI. 

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22 hours ago, al007 said:

Some kind comments, very much appreciated

 

INDIA VS THAILAND having experienced both

 

My observations are as follows

 

I had advanced Holep surgery in India at very affordable cost with technology not then available in Thailand, under USA trained surgeons

 

I expected this to be a one off with little need for follow up, and when my cancers were discovered in India the next step was very traumatic, I had no wish to remain in India for a year plus

 

On my Cancers  I can only say Chulalongkorn in BKK was both some of the best available in the world with very affordable costs, and I am uninsured in no way did it fit into the category like everything at these private hospitals in Thailand,they cost one hell of a lot.

 

I am very happy to be having the follow up done in Bangkok, ( for me one hour flying) where I am likely to have to go for checks every three months for two or three years, and then annually, we also like bangkok and it has some very enjoyable hotels that can with watching come at very affordable costs

 

Also if matters deteriorated I have an excellent team at the Chulalongkorn who know me and will do whatever is necessary, including top surgery

 

I would not want to be doing flights to India every three months then having surgery that might or might not be OK, for my wife BKK is so much better and easier

I would not want to become terminally ill in India, and who knows how long that might last

 

We have a plan on how to deal with long term terminal illness should that happen, at home in KhonKaen

 

When deciding on India or Thailand it is far more complex than just the operation alone

 

My preference will always be Thailand, also the nurses are prettier here, more caring and without a doubt the very best in the world, and to die in their smiling and loving care would be very OK

 

I hope to live a full life but there are no guarantees, and we need a plan just in case

 

 

 

 

 

 

 

 
 
7

Yes self-funding, but how long do the funds last?  My experience of India is just the opposite of yours. My recent prostate operation in India probably in the region of one tenth of Thailands  (one poster another thread, diligently studied this, came up with a figure of 255,000 baht, prob govt.hospital , prob ward and waiting time...etc, seems low figure to me, private hospital would no doubt be in orbit...  Had major probs and urgency .was the name of the game  flew there, just over two months ago  , I paid approx 35,000 baht..private room for 5 days   flights probably around 3000B two hours away, plus fill the bags up with top of the range glasses etc etc.  for me it was excellent result,can keep going there for those  prices

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6 hours ago, bubba said:

Just another note regarding mpMRI:

 

MRI is not only used to help formulate an informed decision regarding a biopsy. If MRI does detect a lesion, then this is used together with endorectal ultrasound to form a fusion image, thus providing much more accurate targeting for the biopsy cores. With a negative DRE and ultrasound image, but without MRI imaging, the urologist is more or less "shooting in the dark" (to make a bad pun) and could completely miss a small but potentially high grade tumour. 

 

While I value an experienced urologist, I also highly value the accessibility of the best tools. Lacking one or the other can lead to a less than optimal outcome. Regardless of the experience and skill level of a urologist, I would never consent to a biopsy without mpMRI. 

 

Bubba's post is probably by far the best and most logical on the question of diagnosing prostate cancer I have yet to read

 

Prostate cancer to positively identify seems to me very difficult

 

An unguided biopsy is like sticking needles into an orange and hoping to find the one bad spot, rather hit and miss

 

 

 

My Urologist in India, USA trained about 42 yrs old, a very bright man, told me after he completed my Holep operation, that around 60% of people having this procedure, who had a biopsy showing no cancer; did when the biopsy of the tissue from the holep was done;  have prostate cancer a rather scary statistic, again highlighting the inadequacies of prostate biopsy alone

I rate this surgeon very highly and the cost was exceedingly reasonable, in fact I have referred a couple of people to him already, and they were also happy

 

 

 

I personally want doctors old enough to have made mistakes but young enough to be fully up to date in their specialist medical field; which in to days world is so very high tech,( and have had experience at the top world hospitals) doctors over 55 may well not fit into my criteria 

 

They also need the best tools to enable them to perform, my oncologist likened the removal or slowing of my cancers to like shooting 100 rabbits on the field, and he needs the most technically advanced equipment, to do the best job, at a later stage there could be thousands to shoot

 

 

http://www.topmastersinhealthcare.com/30-most-technologically-advanced-cancer-centers-in-the-world/

 

My Oncologist at Chulalongkorn, trained at John Hopkins in the top three cancer hospitals in the world, (see link above) he is also late 30's, this is a very high technical field and the older doctors like over 55, often are generally, not up to date, Chula is also a teaching hospital and that should also help to  keep him a little upto date

 

My colorectal surgeon low 40's probably at his prime, and no doubt also made mistakes, and when asked he just smiles, I also say we all make mistakes and thats some of our best learning experience, again he smiles

 

I have four doctors looking after my case, and they have regular review meetings, which I also believe seriously reduces the chances of something being missed

 

 

I do not want a mid career doctor who claims no mistakes because he will either be lying or has never practiced, and that is my opinion

 

I also attach a very interesting link re prostate cancer

https://seer.cancer.gov/statfacts/html/prost.html

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Looked up at start of operation, before head was forced down and covered, counted at least 35 doctors or surgeons looking on, probably being filmed, because of unusual size of prostate, surgeon did take samples but surgeon later stated no sign of cancer

 

  Also stated the prostate (blood wise) was a well-fed organ, that is why black bits are always showing on scans...and don't I know it...even now I get a spot or two

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I have prostate cancer. The normal procedure is first based on PSA value to take MR. If anything found like in my case the next step is biopsi. I was a 7 on the Gleason scale. I decided not to operate. This was a year ago. My PSA value has stayed low due to the diet I have followed. Last MR showed status quo from last year. Next week I will have a new biopsi.


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On ‎6‎/‎5‎/‎2560 at 2:37 PM, Jetwake said:

I have prostate cancer. The normal procedure is first based on PSA value to take MR. If anything found like in my case the next step is biopsi. I was a 7 on the Gleason scale. I decided not to operate. This was a year ago. My PSA value has stayed low due to the diet I have followed. Last MR showed status quo from last year. Next week I will have a new biopsi.


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And where did you have the MRI ?

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  • 1 month later...
On May 5, 2017 at 7:17 PM, al007 said:

OK folks,let's cool down,we are all here, to hopefully help each other. ABSOLUTELY AGREE ! !! !!!

 

Gentlemen you are above my level of competence

 

I believe Chula to be very well equipped with state of the art equipment

 

I do not speak thai but surely someone who does can make a simple phone call and enquire, if they have this most upto date equipment it is pretty certain they are going to be the most competitively priced, on several large ticket procedures Bangkok Hospital were three times more expensive than Chulalongkorn

 

Yes I am a big fan of Chulalongkorn, they have done wonderful things for me

Telephoned both Chulalongkorn and Samitiveg hospitals, no one could give me an answer. Then sent e-mails to both hospitals, surprise,surprise, no answer from ither hospital.

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I have sent email to my oncologist at Chula

 

"As you know I am very appreciative of what you have done for me

I have a friend another expat who has asked me the following, Does Chulalongkorn have 3T MRI I understand it has more sensitivity than the more common 1.5 T"

 

Lets see if I get an answer !!

 

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I have heard that Samtivej has 3T MRI. But an important question is: do they have experience with multi-parametric MRI for prostate? And then, it is very important that the urologist or radiologist is skilled at assessing the MRI results. 

 

I do not know the answer for that at any hospital in Bangkok. 

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43 minutes ago, nontabury said:

Telephoned both Chulalongkorn and Samitiveg hospitals, no one could give me an answer. Then sent e-mails to both hospitals, surprise,surprise, no answer from ither hospital.

 

I have another MRI booked at the end of August

 

I asked my wife to call Chula 02256 4000  Extn 80204, being MRI department they confirmed they do have 3T MRI, like everything in Thailand please double check before accepting what I think is correct, is in fact correct

 

This now prompts me to find out if my next MRI is 1.5 T or 3T, and if not 3T why not ???

My estimated cost next time is bhatt 10,500

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I have done a lot of reading on this subject, and it is clear that 3T MRI offers much better resolution and the ability to detect smaller adenomas, and with better negative predictive value if they do not see a tumour. Also, a 3T MRI can be done without an endorectal coil, which is obviously an advantage. If you can get a good quality 3T MRI done, I have also read about a highly respected prostate diagnostic radiologist in the USA, Dr. Joseph Busch, who will give you a second opinion on the MRI interpretation if you send him the CD you can get from the hospital. I believe his fee for that is US$150.

 

Just having a 3T MRI is not enough. They need to have the ability to conduct a multi-parametric MRI, including gadolinium contrast uptake. 

 

By the way, my own 1.5T MP MRI with endorectal coil at Bumrungrad cost around 30,000 baht about two years ago.

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On 6/13/2017 at 2:32 PM, al007 said:

I have sent email to my oncologist at Chula

 

"As you know I am very appreciative of what you have done for me

I have a friend another expat who has asked me the following, Does Chulalongkorn have 3T MRI I understand it has more sensitivity than the more common 1.5 T"

 

Lets see if I get an answer !!

 

I received this reply just took a little time!!

Dear A, 

The radiology department of my hospital has 3 Tessa MRI machine at  Bhumisiri, the new building. 
Thank you,
Ch
This confirms Chulalongkorn  has 3T MRI
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So Chula does have a 3T MRI instrument. The next questions would be:

 

- Do they have capability for and experience with multi-parametric prostate imagining?

 

- Do they have a radiologist experienced in interpretation of those?

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1 hour ago, bubba said:

So Chula does have a 3T MRI instrument. The next questions would be:

 

- Do they have capability for and experience with multi-parametric prostate imagining?

 

- Do they have a radiologist experienced in interpretation of those?

You are obviously very knowledgable Bubba

 

I suggest you now take over, investigate further and give us all the benefit of your expertise and experience

 

All I have to add is I have a very high level of trust in the experience and expertise at Chula, and affordable cost, but then you also have to wait in line often for upto 5 hrs, but for me I am very grateful to have people I trust at costs I can fund

 

Another hospital up north bought the wife a new car as compensation for negligence,and malpractice;  in fact a very very nice new car

 

So when I rate Chulalongkorn highly I know about the bad and incompetent

 

I look forward to more from bubba !  !!   !!!

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Don’t think I’ll be taking the time to research Chula's prostate MRI capabilities and experience as I am not in the market for one just now. If you are, you should definitely answer those questions before blindly trusting a facility's competence. Any hospital with money can buy. 3T MRI, but that doesn’t even mean they can do multi-parametric MRI for prostate. As well, it does not mean they have an experienced radiologist to do the interpretation, and MP prostate MRIs are complex. 

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12 minutes ago, bubba said:

Don’t think I’ll be taking the time to research Chula's prostate MRI capabilities and experience as I am not in the market for one just now. If you are, you should definitely answer those questions before blindly trusting a facility's competence. Any hospital with money can buy. 3T MRI, but that doesn’t even mean they can do multi-parametric MRI for prostate. As well, it does not mean they have an experienced radiologist to do the interpretation, and MP prostate MRIs are complex. 

Interesting, and maybe a rather negative post ,I thought this thread was about prostate cancer and other prostate related matters,  I  reserve my judgement on its quality , so are you only here to stir the pot, a bit bored with your life, sorry about that.

 

I personally post with the intention of helping others, no other motives, I am also very grateful on life saving help and advice received from Thai Visa members especially Sheryl, when I was in the depths of depression nine months ago and pretty suicidal and unbalanced, I did not know where to go or what to do

 

I have bounced back, yes just for today !

 

I only provided information in reply to others requests

 

God Bless, and May God be with you and your family, I will remember you in my prayers

 

I apologise if I have interpreted you post incorrectly

 

I quietly and with dignity I hope, still intact, withdraw from this debate

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