[Lani]

Could a needle biopsy be done through the nose?

From my reading, pituitary tumors are accessible through the nose. I would surmised (again I could be entirely wrong) only a tiny sample is necessary to test for Na/I symporter (and since ~80% of her2+ mets were positive for Na/I symporter) it would seem to be the safest way to treat your tumors with radioactivity without risking your pituitary or optical chiasm or other important structures. {{Again, this is pure supposition on my part (science fiction, if you will). I have no idea if this is practical, doable, or more likely to be beneficial than harmful. I don't know whether it is something you would want to save up as one last attempt if other treatments aren't as effective as you would like, or something that should be attempted now to protect your vision. I have no qualifications to make my opinion worth anything--having just read a lot of the medical literature and had an active imagination.}}

Otherwise, it would seem your chances of treating this with radiation are too risky and then you are into the realm of "what crosses the blood-brain barrier" or "what can be given intrathecally"?

Stanford is home to one of (what was when I last checked) four MRT machines in the world, which allow biopsies and other surgeries to be done with special instruments while an MRI shows them where they are going.

Normally MRIs cannot be done while operating because of the metal instruments and because they are generally closed cylinders without adequate access or "open MRIs" with poor resolution.

Seems like you might be wanting to check out whether this is just science fiction ie, whether they would still consider you for radioactive iodine teatment and that may involve consulting with neurosurgeons and/or interventional radiologists to see if my understandings about the possibility of a minimally invasive biopsy are just musings or are practical possibilities.

When I last checked, the radiologist who runs the MRT program at Stanford is Dr. Bruce Daniels, who also is an expert in breast MRI.

Remember to check out my previous posts of articles on brain mets, including use of boswellia, intrathecal herceptin, etc.

Good luck!