3T MRI

I have posted on similar issues in the past...but I know that there are constantly new users and thus thought I would seek some additional guidance.

No history of prostate cancer, mid 40s...with PSA's over the last 5-6 years that have ranged from 2.5-3.9....however, the 3.9 was followed by a 2.6 without ABX after a three month wait. In short, lots of up and down numbers, most recent a 3.4

Saw competent urologist from one of the prime teaching hospitals in the Country...and he decided to go with the mpMRI 3T in essence as a screening test in lieu of the biopsy. Seemed generally to make sense to me given that biopsies can have false negatives. I appreciate the limitations of MRI...results consistent with prostatitis, no lesion, tumor or capsule compromise noted.

The plan was to follow up with 2 more PSA's at 6 month and 12 months and reevaluate...sound like a good plan....my sense from all that I have read is that MRI would have picked up anything significant...but potentially not a Gleason 6 small tumor? Am I correct on this....and more importantly what is the thoughts for others on the board as to whether this plan makes sense....I know a lot of individuals are resistant to the thought of a biopsy...will we reach the stage where MRI will place biopsy as second step in screening....and while biopsies clearly can show +/- as to cancer and necessary to obtain paths specimens...keeping $$$ aside...whats your thoughts as to how this will ultimately trend.

Thanks

Hi Bob,

I have now had three 3Ts and the first two showed my G6. I then had focal laser ablation and the third 3T shows no cancer!

I think you made the right call. Most painful part of my experience was the TRUS biopsy. It causes damage so you likely were able to get a better MRI picture by not having it. Hopefully you will not need it but you can have a targeted biopsy while the MRI is in process which focuses on specific areas of concern vs. The "random" biopsy I experienced. Had I known more, I would have followed your path.

Congratulations on the clean results!

I had a 3T mpMRI which was used to find any suspicious areas to biopsy. The oncology urologist saw one suspicious area on the mpMRI. So I had a standard 12 core plus 1 (for the suspicious area). The one suspicious area turned out to be negative, while 4 out of the other 12 turned up positive.

The bottom line, is that the mpMRI can find suspicious areas if they are higher yield, and aren't to small. The ultrasound probe and CT should numerous prostate stones (calculi) which the mpMRI failed to show. My cancer was small yield even for the GS 7 resulting in that the mpMRI was ineffective for the intended purpose.

The only definitive diagnostic tool is the biopsy.