Official January 2010 MRI Results

Today we had our follow-up visit with Isabella’s oncologist to go over the official MRI results.  On Saturday, she reported to us that her preliminary results by taking a quick look at the MRI showed that everything was still good and stable.  Since then, the radiologist (who specializes at looking at MRIs) was able to look at the results, along with some more detailed tests and reported that everything indeed did look good – not only was there no new tumor, but they now suspect that the areas that they thought were tumor on her last MRI are actually just scar tissue from Isabella’s craniotomy.  So basically, what it boils down to is that although our doctor never actually used the word “clear”, she was extremely happy with the results – she remarked that if she felt there was tumor left, that we would have immediately began planning for her next rounds of treatment.  So reading between the lines there, she obviously believes that Isabella requires no more treatments and we will just continue with the periodic scans.  Because of the scar tissue, MRIs will always show enhancement (enhancement is the term they use to show any abnormality in the scan) so I don’t believe we can ever have a truly “clean” scan – that is, this is probably the best report we can expect.
You may also ask yourself if scar tissue and tumor look the same  on an MRI, how can they tell which is which?  Well one of the additional tests that they ran this time (which they were not able to run last time) is something called a “perfusion” scan.  Perfusion measures the amount of blood flow to the enhanced area of the brain.  Tumors, by their very nature, draw a lot of blood compared to normal brain cells.  Right after Isabella’s surgery, a perfusion scan showed that the tumor cells had 8 times the blood flow compared with the blood flow from the surrounding normal cells.  When Isabella completed her chemotherapy, the perfusion scan showed that the perfusion had dropped to just 2 times.  The perfusion scan from this round showed perfusion at 0.9 to 1 times, or normal blood flow from the enhanced areas.
I know that I’ve been through some emotional highs and lows over the last year, but I think a giant weight was lifted off my shoulders when Julianne finally said she was very happy with the results.   Up until now, knowing the grim statistics for pediatric brain cancer, she had taken the cautiously optimistic approach as not to get too high or too low.
But like I said many times before, we will continue to be vigilant even though we’ve past what we hope is the final finish line.  Julianne says that she will continually keep up to date with any advances in pediatric brain tumor research in case Isabella has a recurrence.  She has also remained active in the online support message boards and has been in contact with several parents of newly diagnosed children. 
Throughout the year, we always talked about how lucky we were with the timing of some of the events and how the stars seemed to align in a way that Isabella got the best possible treatment available.  A few times over the last year, Isabella would say something like “When I’m 10…” or “When I grow up, I want to….” or something similar, and I would smile back to her, but in the back of my mind, it made me extremely sad knowing that she might not ever get that chance.  But now, she has that chance.  I don’t think Isabella will ever know how fortunate she was or is, and honestly I hope she never has to know and she can live a full, normal life.
Thank you all for your incredible support.  It won’t be soon, but I hope that one day I will be able to officially close out this blog and that Isabella’s Fight will be finally over.