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Logical expectation from mpMRI?

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Prostate Cancer
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Posted 8/19/2014 8:17 PM (GMT 0)
Is it reasonable to assume that I have the nearly same likelihood of my mpMRI on Thursday showing an upgrade to my biopsy Gleason 6 based on the average post-surgical biopsy upgrades of 46% for low risk AS candidates who choose surgery? I realize that the MRI may not be as accurate as a whole mount biopsy, but shouldn’t my expectation be that the odds are close to being the same?
Posted 8/19/2014 8:22 PM (GMT 0)

No, I don't think so, hrpufnstuff.  The MP-MRI helps one discover whether someone like you has a hidden high-grade cancer.  A 3+4, which is by far the most frequently occurring "adverse pathology" upstaging is definitely not a high-grade cancer.


Posted 8/19/2014 9:16 PM (GMT 0)
I found this study which might be of interest: http://www.ncbi.nlm.nih.gov/pubmed/24215670

CONCLUSIONS:
The present evidence for MRI in focal therapy is limited. mpMRI is not accurate enough to consistently grade tumour aggressiveness. Template-guided saturation biopsies are no longer necessary when a high quality state of the art mpMRI is available; however, suspicious lesions should always be confirmed by (targeted) biopsy.
Posted 8/19/2014 9:50 PM (GMT 0)
I would be pleasantly surprised if nothing of consequence is found. To think that 1 of my 24 biopsy needles just happened to hit a 1mm cancer that is not part of a larger tumor seems highly unlikely to me. Now, if that larger tumor is a 3+4 I guess that's not too bad. My PSA is 9.4; I have to believe something else is going on in there other than that little GS 6.
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