My Latest MRI and Back Story

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.

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.