How you get treated and diagnosed is your business and your choice and I respect that. I held off getting my first biopsy until there was compelling evidence that a biopsy was necessary. Before you go through the expense of a PET-PSMA test you might consider getting a 4K test test done. It’s low cost in comparison to PET-PSMA and has a good track record of identifying aggressive PCa. My 4K test came back with a high likelihood of PCa which turned out to be unfortunately true. If a 4k test comes back with a low probability of aggressive PCa you can factor that into your decision whatever that is. https://4kscore.com/