PSA

Note:
10/20/2023 PSA was 20
06/13/2024 PSA was 27
07/09/2024 PSA was/is 33

Digital exam: Prostate size not enlarged

Does anyone know what else can generate the above PSA numbers?

The next decision is the biopsy. If all else is normal with the prostate, I question the decision/option of the biopsy. If the decision is to go forward, the question moves to which biopsy format. Any thoughts/guidance would be appreciated.

Thank you in advance

* * *Final Report* * *

DATE OF EXAM: Jun 13 2024 12:00AM

OUT 0001 - MR OUTSIDE CD DICOM IMPORT -NBNR / ACCESSION # 154275465

PROCEDURE REASON: The previous report is inadequate.

* * * * Physician Interpretation * * * *

EXAMINATION: OUTSIDE IMAGING INTERPRETATION

Indication for the Request / Reason for Overread: Previous report is
inadequate.

Service Requesting Consult: Urology

Any specific Issue(s) to be discussed: PROSTATE BIOPSY TARGETING NEEDED
FOR TRANSPERINEAL BIOPSY

Images Reviewed: MR without and with contrast of the Pelvis performed on
6/13/2024 12:00 AM

Overread Date: 7/1/2024 9:41 AM

CLINICAL HISTORY: 76 years old being evaluated for prostate cancer. No prior biopsy.
Previous biopsy: None.
PSA: 20 ng/mL (10/20/2023) ;
Prior therapy: None.

COMPARISON: None

RESULT:

Prostate:

Dimensions: 4.6 x 3.8 x 3.4 cm corresponding to a volume of approximately
31 cc.

Post-biopsy hemorrhage: Absent

Peripheral zone: Diffuse mild T2/ADC map hypointensity (PI-RADS 2).

Transition zone: There is transition zone hypertrophy, without focal
abnormalities suspicious for clinically significant disease (PI-RADS 1).

Neurovascular bundle: Unremarkable.

Seminal vesicles: Unremarkable.

Adjacent Organ Involvement: Not applicable.

Lymph nodes: No enlarged pelvic lymph nodes.

Bladder: Unremarkable.

Pelvic bones: No suspicious pelvic osseous lesions.

Other Findings: There are bilateral moderate-sized fat-containing
inguinal hernias.

IMPRESSION:

1. No suspicious prostate lesion. Maximum PI-RADS category: 2.

2. Prostate volume is approximately 31 cc.

==========================================
Number of targets created for MR/US fusion biopsy:
Full gland segmentation performed in Koelis to permit nontargeted
transperineal fusion biopsy.
Peripheral zone: 0
Transition zone: 0

If present, targets were numbered in order of level of suspicion for
clinically significant prostate cancer (Gleason score 3 + 4 or higher).

PI-RADS v2.1 Assessment Categories:
PI-RADS 1: Clinically significant cancer is highly unlikely
PI-RADS 2: Clinically significant cancer is unlikely
PI-RADS 3: Clinically significant cancer is equivocal
PI-RADS 4: Clinically significant cancer is likely
PI-RADS 5: Clinically significant cancer is highly likely

(V.05.2019)