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Are there any guidelines or recommendations on how often we RRMS patients on beta-interferon therapy should get MRIs? Anyone have difficulty with getting insurance to pay for them? My symptoms and MRI in April led to a straightforward diagnosis. No symptoms so far since starting rebif in May. Should I ask my neuro for another MRI in 6 months? In a year?

Thanks for any and all info/advice.

Carolsue,

Your doctor can answer any questions you have about your treatments, including when you get your MRI's. If you are not sure, just ask.

thanks, I will, but I'm asking here because I'm not confident that my neuro is up to date on MS. I don't have many choices in neuros where I live, so these forums (fora?) are a very important source of info for me.

It all depends on your condition. If you remain symptom free, the dr. might have one done once a year for a comparison to the first baseline MRI. If you have new symptoms, the dr. might order an mri at that time.

After my first round of visits and starting on Avonex, my dr said he would do another in a year. Six months later I was having what I thought were new symptoms (it wasn't). He ordered another MRI. I will probably have one at my next visit since it will be roughly 2 years from my first MRI.

Insurance for me is not a problem as along as my doc orders it. The same is true with Physical Therapy and Steroids. It is covered as long as the doc. orders it. Of course, every insurance policy has different rules.

The best description I've heard on when to get an MRI is from Rip Kinkel at the Beth Israel in Boston. He said he only orders an MRI when he can say how he will alter your treatment based on various results. E.g. if it's not changed from last time he won't change your treatment and if new lesions appear he'll do steroids (I'm making up these treatments for illustration).

But that makes sense to me. Many neuros get an MRI and no matter what the results are, they don't change the treatment. So what was the point of the MRI? Curiosity?

Most neuro's seem to do MRI's every 1-2 years. Others will do them every 6 months. Unless your disease is very active I don't think anyone would do them more frequently than that.

I'm curious, so like to see them more frequently just for the interest. Getting into a study (particularly a natural history study that doesn't require you to change therapies) that involves MRI's is a one way to get them more frequently.

Art,

Yes, I've had the same experience w/ my neuro. I asked when the next MRI was going to be... She said something to the effect.... It doesn't matter what it shows... we're going to continue on current therapy....

If it's the same - the drug is working...
If it's worse - you need to be on the drug...

Seems so arbitrary to me, and they likely know how often 'so and so insurance' allows them if you're not showing any disability scale type symptoms...

Regards
=G

Seelie,

My neuro said the same thing to me last month. He said by all accounts I'm doing well. He doesn't feel that an MRI is needed at this time. If we were to do one right now and it showed more activity, we wouldn't change the current plan. If I wasn't doing well and the MRI also showed activity, then we would address the issue.

I don't have a problem with that. If he says I'm doing great and "see ya in 6 months". I'm not going to argue with the man

If I wasn't doing well, my visits to him would be much more frequent.

Cheers,
Niko