MRI results

dp60544

just saw results on my husbands patient portal. Not really sure what they mean. Also didn’t know if I should’ve put this on my original topic , so I just started a new topic, hope that’s ok.

FINDINGS:

There is mild hypertrophy of the central gland with a total gland volume of

21 cc.

The prostate gland measures 4.0 x 2.9 x 3.3 cm.

PERIPHERAL ZONES: There there are heterogeneous ill-defined T2

hyperintensities throughout both peripheral zones as well as mild enhancement

on postcontrast images and minimal restricted diffusion. In the right

posterolateral peripheral zone at the gland base, there is more defined area

of abnormality which measures 1.0 x 0.8 x 0.7 cm. The findings are

nonspecific and may represent a sequela of inflammatory process/prostatitis.

Low grade malignancy cannot be entirely excluded.

TRANSITION ZONES: No suspicious for malignancy lesions seen in the

transitional zones.

EXTRACAPSULAR STRUCTURES: The neurovascular bundles and seminal vesicles are

intact.

There is no evidence for lymphadenopathy.

There is no suspicious pelvic bony lesions.

The urinary bladder is intact.

The rectum is intact.

IMPRESSION:

1. Mild hypertrophy of the central gland with a total gland volume 21 cc.

2. Nonspecific appearance of both peripheral zones with more defined area of

signal abnormality in the right posterolateral peripheral zone at the gland

base which could represent a sequela of focal prostatitis. Low grade

malignancy cannot be entirely excluded.

3. The capsule, neurovascular bundles and seminal vesicles are intact.

4. No evidence for lymphadenopathy or suspicious pelvic bony lesions.

PIRADS: 3 INDETERMINATE

Old Salt

That's a very hopeful report. No obvious cancer detected by MRI.

Now let's take a look at the earlier thread:

https://csn.cancer.org/discussion/328106/husband-was-misdiagnosed

I suggest follow-up PSA testing on a regular interval (3 months). Perhaps a biopsy now or as soon as there's a further rise in PSA.

VascodaGama

Hi,

I think it better for you to keep posting in the same thread for cohesion of your case. In any case, the MRI report indicates a relatively small gland (volume 21cc in 4.0 x 2.9 x 3.3 cm) that may rule out the suggested BPH issue.

Your next step is a biopsy to verify the reason for the constant increase of the PSA.

Let's cross our fingers for a negative result.

Clevelandguy

Hi,

Agree with Vasco and Old salt, I would think a biopsy would be next.

Dave 3+4

Rob.Ski

That is good news on MRI but, they aren't confirmation of cancer or no cancer. My first MRI was clean when my PSA was rising, 6 months later biopsy confirmed PCa. Even a negative biopsy has possibility of missing cancer. Again it's good news but, rising PSA needs to be monitored. Agree with others on biopsy.

dp60544

Husband had his biopsy and just got the results. They took 12 samples and 5 were positive with a Gleason score of 3+3=6. Doctor said his options are surgery to remove the prostrate or radiation. We are leaning towards surgery. Just wondering what you all think and have done? He’s 53 and in good health otherwise.

Old Salt

Surgery is certainly an option for a man that young. I suggest you both also look into Active Surveillance.

With respect to surgery, do look at all the possible 'after' effects prior to making a decision.

Wheel

i would ask the Doctor for the ExoDx Urine marker test. This is for PSA’s 2-10. This is a very easy test that is non invasive to assess the risk of having clinically significant or high grade prostate cancer. This could help decide whether to proceed with a biopsy now or wait and follow more PSA tests. If the number is below a certain number it gives you confidence if you want to continue to follow the PSA for some additional time without the biopsy. If it’s higher than the threshold you could go forward with a biopsy now. If the PSA continues to rise over the upcoming year, you have the baseline MRI and if they perform another MRI in the next year they can compare the two. My second MRI showed changes and a fusion biopsy was able to directly address those areas.

Wheel

just read biopsy was done. Definitely at his age, consider Active Surveillance but well monitored. You could also now have the Doctor send off for the genomic Decipher test