Posted 12/23/2021 4:51 PM (GMT 0)
I have had steadily rising PSA with occasionally spikes above the trend. The trend is about 1.7 per decade. Recent values were 3.7 (on trend) this summer and 4.9 (a spike) last month. Due to the most recent spike, my urologist ordered a mpMri and I was able to download the report. Gland is 46 cc and there is some benign hyperplasia in the transition zone. There is a 0.8 x 0.4 cm PIRADS 3 lesion in the right posterior apex peripheral zone that "abuts the capsule less than 1 cm". And there is a 1.4 x 1.4 cm PIRADS 3 lesion in the left posterior base transition zone that "abuts the capsule greater than 1 cm without capsular bulge or other irregularity" and is "possibly lenticular shape". I am 73 years old.
Should I get a second reading of the MRI or should I go straight to fusion biopsy? My urologist down played the results and said that I didn't need to do anything now and we could discuss further during my next appointment in about 6 months (maybe because all the local hospitals are full of covid patients).
Looking at the PIRADS v2 pdf manual, it looks like if the shape of the second lesion was lenticular as suggested, that would up it to PIRADS 4, and if also the size was read as 1.5 cm instead of 1.4, that would up it to PIRADS 5. Has anyone had a reread on a mpMRI? Who is best for a second opinion on a mpMRI? (ie the Epstein for mpMRIs)?