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My Attempt To Get An Mri Approved For Microhematuria Follow-up

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Posted on Sun, 5 May 2019
Question: My attempt to get an mri approved for microhematuria follow-up was disallowed. They want me to repeat a ct that I did 16 months ago which I want to avoid since I've had 10+ cts in last 8 years mostly for lung nodules(17) Dr Chail indicated that he thought mri was superior for small and soft tissue masses. I'm trying to present info in my appeal supportive of mri. They are referencing AUA guidelines(2112/2016). Microhematuria has increased to 10-25 rbc's from scant(16 months ago) on 2 tests. I appreciate anything you can do to help.
Thanks! XXXXXXX XXXXXXX
doctor
Answered by Dr. Vivek Chail (9 hours later)
Brief Answer:
We can consider an ultrasound scan first and then re think the CT scan

Detailed Answer:
Hi,
Thanks for writing in to us.

Research in imaging is happening every day and the referenced article I mentioned was dated March 2017. The time to incorporate research suggestions to clinical practice can take few years with the support of amendments to guideline such as AUA and you can see that the guidelines were 2012 and 2016.

I suppose your medical facility will continue to follow treatment protocols till new amendments are done.

In this scenario, I can suggest you to get a ultrasound scan done to see the parenchyma of kidneys in detail. In radiology, out rules say that a CT scan may be done where benefit is greater than the risk of exposure. Therefore a single CT scan for the purpose of detailed imaging may be acceptable, even though it might cause a slight increase in the relative risk associated with radiation dose.

Regards,
Above answer was peer-reviewed by : Dr. Kampana
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Answered by
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Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6873 Questions

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My Attempt To Get An Mri Approved For Microhematuria Follow-up

Brief Answer: We can consider an ultrasound scan first and then re think the CT scan Detailed Answer: Hi, Thanks for writing in to us. Research in imaging is happening every day and the referenced article I mentioned was dated March 2017. The time to incorporate research suggestions to clinical practice can take few years with the support of amendments to guideline such as AUA and you can see that the guidelines were 2012 and 2016. I suppose your medical facility will continue to follow treatment protocols till new amendments are done. In this scenario, I can suggest you to get a ultrasound scan done to see the parenchyma of kidneys in detail. In radiology, out rules say that a CT scan may be done where benefit is greater than the risk of exposure. Therefore a single CT scan for the purpose of detailed imaging may be acceptable, even though it might cause a slight increase in the relative risk associated with radiation dose. Regards,