pirads 3 in the indeterminate Zone
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7 months ago I had a 3T MRI which showed pi-rads score three in the indeterminate Zone. my first urologist wanted to do a normal prostate biopsy and not a fusion one. my second opinion urologist at the Cleveland Clinic said a fusion biopsy was indicated but it had been long enough that he wanted to do another 3T MRI first. neither one of them and I didn't know to ask indicated that a score of 3 was equated to any certain likelihood of cancer. I figured that with a $5,000 deductible to be met I'd be better off having another 3T MRI and the fusion biopsy since either one would probably cost more than that. I've had rectal pain for year-and-a-half which has responded well to internal physical therapy. I have also had pain in what I will describe as the vas deferens areas beginning at the epididymis and extending up towards the prostate. I have had prostatitis for over 40 years and I remember exactly how it started. it began with soreness in both testicles extending and itching on both sides up towards the prostate for a week when it hit the prostate it caused unbelievable pain. I'm wondering if my current pain in the vas deferens is being caused by urine back up because of an enlarged prostate which may or may not be involved with prostate cancer. I'm thinking I'm going to have to bite the bullet and get another 3T MRI and fusion prostate biopsy.
0 likes, 3 replies
jwrhn1951 rolf61809
Posted
I'd definately have another 3T MRI at the Cleveland Clinic. The great value of any MRI is being able to compare a current one with a previous one to detect clinically signifigant changes. They have an outstanding reputation so I don't think you could go wrong.
geoff90305 rolf61809
Posted
Hi rolf, when you had the mpMRI, did they provide any staging comment? The PIRAD 3 is sort of, we think you "may" have an issue, and sort of in the middle area for probability.
P1= Most probably benign
P2= Probably benign
P3= Indeterminate - could be either way
P4= Probably malignant
P5= Most probably malignant
What is your cost of mpMRI? Here in Australia, they are about AUD$500. I have never had a biopsy of any kind, so no idea of those cost. IF you are going to have a biopsy, and it sounds like you may need one, it should be guided. When you have the biopsy results, you can see the Gleason score which is super important in deciding what next. Gleason < 6, you have time to consider what to do about it, as while you may have PCa, it maybe indolent(very slow growing)
Gleason >6, you need to make a decision what to do next. This range of Gleason may need attention.
It sounds to me,,,with no qualifications whatsoever, you have chronic prostatitus with BPH. I would get a new mpMRI on the 3T machine with some radiologist group who is experienced with producing mpMRI images and reading them. I am very anti biopsy unless I have to. Maybe another PIRAD3 score is a reason to have the guided biopsy
barney34567 rolf61809
Posted
If the MRI will show a PIRADS 3 or higher then I suggest a transperennial u/s guided fusion biospy ASAP. That is the biopsy I had and it is definitive.
I understand that CC has a very good name in urology and am pleased that my Australian doctor applies similar protocols.
Good luck.