MRI result

Hard to say. From what I've read, MRI's aren't very sensitive, but are pretty specific. In other words, they're rather likely to miss something, but if they see something it's more than likely there. Does that make any sense? Gleason 8 is high risk, so getting outside the prostate capsule is certainly possible.

Did you get the radiologist's report from the MRI? What they're seeing takes some fairly experienced interpretation by a trained expert. They use specific words based on probability and clarity of what they're seeing.

What kind of MRI? 1.5T, 3T, contrast-enhanced, diffusion-weighted, endorectal coil, whatever?

My 3T MRI scans pretty clearly showed what was going on in my situation, which is one big reason I ended up going with radiation therapy - IGRT by IMRT on a Varian Trilogy with RapidArc.

My situation is a little different and the treatment right now is just buying time with 4-month Lupron, and soon monthly Xgeva will be added to help prevent any bone damage.

In short term no surgery, no radiation, no seeds, no proton, no chemo etc.

At initial diagnosis bone mets were observed. My caution would be that urologists and medical oncologists tend to rely on the report and not the bone scan itself. The report contains CYA language like multiple thoracic bodies and right posterior ribs which led both of my urologists to believe I was stage IV with cancer having spread throughout my body.

I am stage IV but once I got the radiation oncologist to review the slides for a count of tumors that UF & Shands required on its admission form into Metastatic Disease program, it turns out I was Oligometastatic (<= 5 distant tumors outside the prostate).

Since then that radiaiton oncologist relocated and I have gotten a new radiation oncologist affiliated with a national cancer center. He found the comparison of my two bone scans inconclusive and ordered MRIs of thoracic spine and sacroiliac.

It turns out that the brightest spot on the bone scan was actually benign and was the result of a previously undiagnosed herniated disc at T7-78. My thoracic metastasis was downgraded to mild with lesions at T4 and T9.

The pendulum swings both ways with respect to MRI being more specific than bone scan.

However the MRI of pelvic area which only shows as a non symmetric dot on the bone scan turned out to be more than mild metastasis on sacral ALA and femoral neck.

So my experience is what the previous poster said that the MRI can be more specific than the bone scan but the bone scan is better at overall detection of bony mets.

I also had a CTC Circulating tumor cell test that detected no tumor cells which gives some hope that disease is not growing.

Sam, with respect to your question on could it somehow be non-cancerous, that was my experience with the bone scan. However the MRI which is your diagnostic tool was more specific in identifying T7-T8 as non cancerous but not T4 and not T9 nor the sacroiliac which radiation oncologist described as classic prostate cancer metastatic to bone.

If you had been relying on bone scans as I was, I would have recommended MRIs but you appear to already be there.

LupronJim