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3t-mpMRI results

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Posted 11/10/2015 6:21 PM (GMT 0)
Hello Men,just came back from visit with Uro to discuss my results.He seemed to down play them but when Wifey and me read them on the way home we are very concerned.My Fusion guided Biopsy is next Wed.Here are my results:
The prostate measures 3.3x4.7x3.5cm in anterior to posterior x transverse x craniocaudal dimensions.Prostate volume is 27.4 mL.PSA density is 0.21 ng/ml based on the most recent reported PSA.
Most suspicious lesion labeled lesion #1 on this study is in the left mid to lateral apex of the gland.This lesion measures 7x5x6mm.There is markedly decreased T2 signal.There is low signal on the ADC map consistent with diffusion restriction.Legion demonstrares malignent enhancement characteristics with wash out as well as increasd rate of influx(Ktrans) and increased rate of effux(KEP).This lesion is highly suspicious for prostate malignancy
Second lesion was in the right medial base.This lesion measures 8x5x6mm.This demonstrates mild decreased signal on the T2 sequence.There is no significant effusion here. Lesion demonstrates borderline malignant contrast enhancement characteristics with wash out and increased rate of influx and efflux.This lesion is of moderate suspicion.
Both of these lesions were marked with regions of interest for purpose of transfer to the ultrasound biopsy fusion unit.
Impressions:Mri demonstrating highly suspicious lesion in the left apex and modertly suspicious lesion in the right base.These lesions were marked with regions of interest for purpose of transferring to uro-Nav softwear for ultra-sound-guided biopsy.

Anyony have similar Dx,or anyone can translate some of this would be helpful.It sounds like Im in the Hurt Locker with these findings.Gees,and this is only the beginning.Thank You,SemperFi,0311
Posted 11/10/2015 7:14 PM (GMT 0)
You will find out more after the biopsy. To me, it sounds like your doctor does not want to speculate, which I appreciate. The scan results now provides them a better target for the biopsy. With your rising PSA and the scan findings, it is prudent to look for cancer, hence the tests. Until you find the cancer and understand the grade, you can't make any determination as to severity or treatment methods. Try not to get ahead of yourselves. You are in a good process, just have to work through it objectively.
Posted 11/10/2015 7:21 PM (GMT 0)
Thanks JNF,.
Posted 11/10/2015 9:29 PM (GMT 0)
It's confusing and complicated and I think that frequently translates to alarming. I'd just sit back and wait for the biopsy so you have some more definitive information. I know that's easier said than done, but it's very easy to get worked up over "what ifs" when it comes to all of this. In the meantime, sending positive thoughts your way!
Posted 11/10/2015 10:20 PM (GMT 0)
Hello 0311

I don't know if this will help you, I hope it does as I sense you are a military man.

I'll share something that got me through the shock of finding something on my own MRI...

"You now KNOW where the enemy is, you can see him clear as day, he's given away his position and you can put that mutherfarker in your cross-hair and blow his ass clean off any time you want to!" ...the only thing that's stopping you right now is that you're gonna take a measured breath and get a scout to go check on what weapons he's carrying and how dug in he is; so you know exactly how hard you have to reign down all hell fire on that b*stard to get the job done...

I can see my space invader... which now makes ME the dangerous bad-ass-mofo!

Have fun with that notion dude, push your shoulders back and be empowered.

Paul
Posted 11/11/2015 12:14 AM (GMT 0)
I'm surprised the radiologist didn't use the PI RADS scoring system to assess the areas of suspicion. Anyway, you are doing the sequence in the right order, ie, mpMRI first and biopsy second. Yes, it sounds like you could have some areas of PCa but they may be low grade. At least the urologist knows where to target.

I had the blind biopsy which showed 5 positive cores, all 6s, and then had the mpMRI which showed 3 suspicious lesions which matched up with the area where 3 of the cores were positive. Thus the MRI didn't pick up the other 2 areas where the cores were positive.

So mpMRIs are useful, but not definitive at this point.

Good luck and let us know what they find.
Posted 11/11/2015 1:01 AM (GMT 0)
Hey Paul 65,good advice.Its funny I was in a Recon unit and thats exactly what we had to do.But this crap has no fear.Next Wed. the Biopsy then a week of more waiting for results.Thanks SemperFi,Brother
Posted 11/11/2015 1:09 AM (GMT 0)
Hello dcd55,the Pi-Rads are not on the print out anywhere on the offical report.I also put that report on this site a little earlier today.I did ask the Uro what was the Pi-rad because I had that in my questions on a piece of paper to ask him.I swear he looked at the same report that he gave me and he said a 4.That the Pi-rad was a 4.Would there be 2 Pi-rads scores for 2 lesions? I might call the Radiologist at the hospital tomorrow and inquire. Thanks for the input.
Posted 11/11/2015 1:13 AM (GMT 0)
0311, each lesion/area of suspicion noted on the MRI gets a PI RADS score.
Posted 11/11/2015 1:18 AM (GMT 0)
Thanks Michael T,for the positive thought.One more thing.My Uro did mention Brachy how its not what the establishment thought it would be.He down played it.But i am doing research the last month and it might be one of my choices if I need it.Thank You,SemperFi,John
Posted 11/11/2015 1:48 AM (GMT 0)
Thanks Again,dcd55
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