prostate MRI

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Biopsy 3 years ago wit 1 core abnormality. 3 years later mri as my psa is fluctuating, Pi rad 3, everything else is normal. Anyone else with similar situation?

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  • Edited

    PIRADS 3 is not great, but I'm a PIRADS 4 guy and you don't want that. 3 is much better than 4.

    You mention your PSA fluctuates.

    Are you getting it checked by the same lab each time? You should.

    What are the most recent measurements?

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  • Edited

    Don't be too worried. i had a PSA of 12 in June, had MRI which came back Pirads 4, so then template prostate biopsy in August. no cancer found. Outcomes can be positive. PSA fell to 7.8.

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    • Posted

      May I ask a question? Was the radiologist who diagnosed "no cancer" a person with a high reputation? That is, is he/she well regarded AND one who focuses ONLY on prostate imaging?

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    • Posted

      Good news.

      What I was trying to indicate was that it's best to have prostate images analysed by a radiologist who specialises in prostate as opposed to a "generalist" radiologist.

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    • Posted

      That is good to hear.

      PiRADS 4 on the MRI is what I had. If cancer is detected in a biopsy then it's a pretty nasty one. But then again, cancer may be absent with a PiRADS 4 diagnosis.

      If I were you I would check PSA levels say in 3 mths time and compare it to the last two PSA readings.

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    • Posted

      Thanks for the advice, i have my PSA done every 6 months. i had one done in Dec 2020 at 2.98, then one in Jun 2021 at 12, Jul 2021 at 7.8, it was the PSA of 12 that got me the MRI and then the biopsy.

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    • Posted

      Did you have the PSA tests done in the same lab? I ask because different labs have slightly different ways of measuring. A general rule is that one should consider cancer if the PSA doubles in a year.

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    • Posted

      i dont know as it is done by the UK NHS some by my GP and others by the hospital phlebotomy dept. My PSA went from 2.98 to 12.00 in 6 months hence the biopsy to check for prostate cancer. They found none this time but the PSA monitoring will continue every 6 months, next teat is in December

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    • Posted

      Interesting.

      It is said that MRIs should be read by experts in prostate imaging to best understand if what looks like PIRADS 4 is indeed PCa. Many radiologists miss he PCa, if it's there.

      It now doesn't matter how good or bad the radiologist was because you had the biopsy which showed no PCa.

      If I were you by all means monitor the PSA every six mths, ideally at the same place.

      Also ask a urologist, your one or another one, what could elevate the PSA so much in such a short time but not impact on the PSA. That is raise the PSA but is -ve for PCa

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