My Latest MRI and Back Story

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  • Old Salt
    Old Salt CSN Member Posts: 1,679 Member
    #22
    https://csn.cancer.org/discussion/comment/1720936#Comment_1720936

    A nice Valentine's Day present!

  • centralPA
    centralPA CSN Member Posts: 424 Member
    #23
    https://csn.cancer.org/discussion/comment/1720946#Comment_1720946

    Good question on the scan lighting up the known lesion. From my report, highlighting the section on my lesion:

    IMPRESSION: PSMA PET/CT demonstrates:

    * Moderate radiotracer avid region in the left posterolateral mid to apical prostate, PCLS 3 = Equivocal lesion, Close follow-up is advised or patient may get benefit from tissue sampling if clinically indicated.

    * No findings to suggest distant metastatic disease on this PSMA PET/CT.

    * Right acetabular ill-defined osseous lesion with faint radiotracer uptake, unchanged in size from 2021 MRI and likely benign fibro-osseous lesion. PCLS 2.

    * Nasal cavity with moderate to intense radiotracer uptake without definite CT correlate, likely inflammatory. PCLS X.

    * Multiple nonacute incidental findings on CT, as described above

    So not a super strong hit on the prostate lesion. The signs of the osseous lesion is what let to all of the imaging. All good, fingers crossed for myself, and best hopes for all those not quite as lucky as I am.

  • swl1956
    swl1956 CSN Member Posts: 267 Member
    #24
    https://csn.cancer.org/discussion/comment/1720993#Comment_1720993

    I am unfamiliar with PCLS. Is this a rating system for Prostate Cancer Lesions on bone? Even as good as MRI and PET scans are, there seems to be some ambiguity in interpreting them. I've read where they're working on and some are already using AI programs to improve the interpretations. Also sounds like they can biopsy lesions if things progress. Stay vigilant and Keep up the good luck!

  • centralPA
    centralPA CSN Member Posts: 424 Member
    #25

    From my report, which was one of the more informative ones, a nice guide for the novices:

    Report
    PSMA-PET/CT Prostate Cancer Likelihood Score (PCLS):

    • PCLS 1 = No lesion to suggest PC: normal PSMA uptake, no CT findings consistent with PC.
    • PCLS 2 = Probably benign lesion: faint PSMA uptake (equal or lower than background) in a site atypical for PC.
    • PCLS 3 = Equivocal lesion: faint uptake in a site typical for prostate cancer or intense uptake in a site atypical for PC.
    • PCLS 4 = Probably PC lesion: intense uptake in typical site of PC, but without definitive CT findings. Alternatively, mild to moderate uptake with definite CT abnormality.
    • PCLS 5 = Definitive PC lesion: intense focal uptake in a typical site of PC with either definitive CT correlate or in the prostate (since CT is not useful for prostate characterization).
    • PCLS X = Probably a false-positive finding of moderate-to-intense PSMA activity from either pooled excreted urinary accumulation (e.g., TURP) or contamination, as well as some nonspecific binding to physiologic tissue (such as sympathetic ganglia, etc.) or sites of infection/inflammation.
  • centralPA
    centralPA CSN Member Posts: 424 Member
    #26

    Active Surveillance update…just got my summer PSA done, numbers look good, but at first they didn't!

    I had a test early Monday morning, done via an order from the VA doctor, that returned a result of 1.63, up significantly from the 1.07 that was six months prior. Small yikes.

    But I thought about how I'd spent the weekend prior, on both days I went on long bike rides and did them without padded shorts. Lots of pressure in the groinal region, so to speak. Wondering if that could impact the result, I used my standing order from the non-VA community care urologist to get a second test 2 days later, with no riding on the days in-between.

    That result was only 1.14, which is way more in line with the minor growth trend to date. So all good, when coupled with the Scan-a-palooza from this past winter. Active Surveillance will continue. I meet with the med folks later this month for the six month check-in. Curious to see if they recommend a biopsy, or feel that the MRIs, bone scan, and PET scan were enough.

    The PSA history…
    Oct 19: 3.9,
    Oct 21: 5.29,
    Dec 21: 5.76,
    Apr 22: 5.1 (taken just before HoLEP for BPH),
    July 22: 0.4 (3 months after HoLEP),
    Jan 23: 0.77,
    July 23: (0.87, 1.0) (had two readings with a week of each other)
    Dec 23: 0.86,
    July 24: 0.97,
    Dec 24: 1.07
    Aug 25: (1.63, 1.14) two readings two days apart, first after two hard days of cycling, second after two days rest)

  • Old Salt
    Old Salt CSN Member Posts: 1,679 Member
    #27

    Glad to see that the second test was a lot more comforting.

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