SEQUENTIAL SCANNING? Patients ask me why their scans have to be repeated. The modern methodology, for monitoring prostate cancer, historically, was putting needles into the prostate on a regular basis. We didn’t have scans that were accurate enough to monitor people. But now, with new imaging techniques such as 3T multiparametric MRI, we can actually see the small cancers within the gland. That of course can be monitored over time. These scans not only have the ability to see the cancers, but they can determine if there is a change or if they are growing over time. How much they are growing and over what period of time do they grow. This is the new basis for our determination - whether someone has a cancer that safe enough to continue to be watched, or rather something that is growing too quickly, and needs some sort of definitive treatment.
Different situations arise when people consider prostate scanning on a sequential basis. For example, the typical scenario, if someone has a favorable scan, and wants to keep track of what’s going on, would be to get a check up on an annual basis. There are situations that arise however, where small abnormalities are seen may be ambiguous, we’re not quite sure, if they are actionable spots or we should be worried about them. In that scenario, we will consider repeating the scan again, after only six months. We also consider other alternative forms of imaging such as color Doppler ultrasound in addition to 3T multiparametric MRI imaging -- to try and determine if a small abnormality looks like it could be worrisome or not.
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