Question about Follow Up's CTA or MRA?

Hello every one.

My first follow up is approaching in March 2011 and was wondering how many people have a CT vs MRI for their follow up's?

My doc gave me a prescription for my 6 month post GK follow up for a CT, but I'm not too keen to expose myself to unnessisary radiation if a MRI is good enough. Many of you state you had a MRI MRA for your follow up appointments, so I would like to see what other doctors are asking from you.

Why my concern?
MRI radiation is similar to your cell phone (Magnetic raido waves) and less risk vs CT (Xrays)

My doctor wanted an angiogram as my 1st follow-up scan but I declined that for various reasons. So they told me to get an MRI/MRA combo and I go in on Tuesday. I’m glad to know it’s less radiation than a CT scan!!

My husband can't have MRIs because his clips are of an unknown metal, so he gets CTs and angiograms.

The doctor said that MRIs are the best way to view AVMs, and if he could have an MRI, he wouldn't need the angios.

It's possible there's something unique in your case as well, but it's worth talking about with your doctor.

I’ve only had MRI follow-ups, although my doctor wants me to have a angiogram done within the next couple months. (i hate those!) I share your concern with the excess radiation though…especially coming off cyberknife treatments.

The excess radiation is definitely a concern. My daughter has had 13 catscans, so I am acutely aware of the radiation risks. But for me, I want the angio for my daughter because it’s the gold standard for detecting any phase of an AVM.

I have only had one CT when I had my seizure after my embolizations I have always had an MRI from what I understand the best way to see the AVM is with an MRI. I hvve also had a few MRAs due to other reasons.I have had more MRIs then I can remember 2-3 a year for the last 7 years. I wish I could be more help.Good Luck

Thanks for your replies, I hope my doc agrees with MRI for my follow-up’s.

 I only had MRI's done.  Every 6 months for a year, then once a year.   When my 3 yrs was up from having the GF, Then I had a an angio done.

In 16 years a CT scan has never been suggested to me. I have had 12-14 MRI scans and 5 angios. The MRI for the quick look, and an angio if they need to see the clear detail.

Hi Brett~~~~My doctor I think does MRI’s vs CT’s every 6 months because it shows the avm better and if my brain is getting “angry” from the radiation from gamma. If I where you call and ask the nurse at the dr’s office why they are going with a CT and not MRI. It never hurts to ask and you can even mention about the site and how most of us have MRI’s for the follow ups. Best of luck ~andrea~

OK update, I called the Doc's office and talked to his assistant. She said they always and only do CT with contrast for AVM's "CTA" as it shows what they need to know better than MRI. The other reason she exclaimed was they need a CTA to compare with the CTA they did while the halo was on prior to GK. I expressed my concerns along with what most of our group's doc's recommend and she asked me to call back on the 15th so I can speak to him directly. So I'm looking forward to a heated argument learning his professional reasoning for his preference :).

Would any one else like to share what their doctors recommend for follow up's??? Has anyone had only CTA followups and why?

Hi Rebecca,

I have had 3 CT's

  1. At ER when they first diagnosed and found something that was suspicious, then it was strait to the MRI/MRA for a better look and confirmation it was an AVM and not a tumor etc. After that they did the Angiography for a more detailed look at the structure, flow etc.
  2. Prior to GK I was set up for CK and they did both CT & MRI for the CK setup. After researching I changed my mind just before CK treatment and went with a new Neurosurgeon & GK.
  3. Then one more CTA for the set up for GK with the new Neurosurgeon. "I have never seen a Neurologist"

For my understanding the CT is standard practice for the software planning on of the either GK or CK treatment? For the CK set up they wanted a CT with the face mask clamped to the table. Same thing with the GK, the CT was necessary for the GK planning software while the halo was in place. Are you sure you never had a CT for the GK planning set up while you had the halo fitted? It was explained to me the halo acts as a reference point to the location of the AVM.


Rebecca Lamb said:

First question is; Is this the neurosurgeon or the neurologist?

I’m a happy camper today. I didn’t get to talk on the ph with my doc like I was hoping but his assistant passed on the message and my concerns etc about the CT. Apparently after some head-scratching, umm and ahhrring he agreed to write a new prescription for an MRI/A for follow-ups. The reason why CT is his preferred choice seems I guess, he’s been working with CT so long and it has proven to work for him so he hasn’t changed what’s not broken. Well I’m so happy he agreed to mix his many years of experience with some new safer technology just for me :-).

I think you are super super smart to make this request Brett. I agree with you 1000%. there is alot of radiation with CT’s.
My son always has MRA s to check his AVM and MRI s to check for bleeds and when he had brain swelling.
So glad that worked out for you.

Brett D said:

I’m a happy camper today. I didn’t get to talk on the ph with my doc like I was hoping but his assistant passed on the message and my concerns etc about the CT. Apparently after some head-scratching, umm and ahhrring he agreed to write a new prescription for an MRI/A for follow-ups. The reason why CT is his preferred choice seems I guess, he’s been working with CT so long and it has proven to work for him so he hasn’t changed what’s not broken. Well I’m so happy he agreed to mix his many years of experience with some new safer technology just for me :-).

Thanks Joy, We are so lucky to have a site like this and the support from our members to help us find the answers we need. It's funny each time I need answers I find them in the most interesting ways either online or just bumping into people at the rite time. For example I met this guy just yesterday as a new client. I discreetly asked him without letting him know I have an issue, what he feels about MRI vs CT? and his answer was CT should be only used when necessary to diagnose certain conditions and it should be one of those decisions based on "dose the radiation risk outweigh the benefit". In an emergency maybe but in a follow-up probably not.


Joy said:

I think you are super super smart to make this request Brett. I agree with you 1000%. there is alot of radiation with CT's.
My son always has MRA s to check his AVM and MRI s to check for bleeds and when he had brain swelling.
So glad that worked out for you.

I got my MRI results back which show maybe a small shrinkage but my doc changed his mind doesn’t want MRI for follow ups anymore, He wants CT next time in another 6 mo at the 12 mo point mark. I don’t understand why and what’s the big difference if he can compare them to the previous MRI/A’s. To me the MRI/A looks just as clear if not clearer. Sigh! Results and drama this way

Brett, that’s an interesting perspective on the CTs. I was told that the CT was best for looking to see if there is an active bleed, but not much else. In fact, my daughter’s radiologist told me a few weeks ago that there are only two tests she should ever ever – CT if there is an emergency and concern about a possible bleed or a cerebral angio for definitive answers. In fact, my daughter has had 13 CTs, and doctors now worry about the radiation exposure since a single CT is now known to have as much radiation as 500 x-rays. Last thing we want is to beat an AVM and then have a brain tumor because of the radiation. It’s so hard when doctors seem to have such a difference of opinions on how to follow-up with AVMs.