Speaking as a newbie (everything's happened since 3/2024) whose PSA spiked from 2.89 to 3.62 over a 15 month period, I was really glad my urologist recommended an MRI and a PSA retest. The PSA retest dropped to a 3.26 (false signal), but the 3T MRI showed an 8 mm lesion with a PI-RADS 4. Then I was really glad my urologist recommended I go out of town to get an MRI Fusion biopsy (which I was ignorant of at the time), with the idea being the MRI fusion biopsy gives the best chance of the biopsy actually sampling the lesion. I went to Mayo Phoenix for the biopsy, but they first gave me a 2nd opinion from both a urologist and a 2nd reading of the MRI from their radiologist who also classified it as PI-RADS 4. At that point Mayo also agreed an MRI fusion biopsy was needed. The reason I really wanted the MRI fusion biopsy was because if the biopsy came back as non-cancerous, I really wanted confidence they had sampled the lesion. However, the biopsy came back with multiple 3+3 = 6 and 3 + 4 = 7 samples, so I elected nerve sparing RALP in late June at Mayo Phoenix. The prostate biopsy after surgery found both Cribiform and IDC, indicating likelihood of aggressive treatment resistant cancer in prostate, but the margins were clear. So 4 months into this foray, I'm pretty glad I had access to a 3-T MRI (and not some older MRI which might or might not have imaged the lesion) and that I didn't delay getting the MRI or the MRI fusion biopsy. I'm also glad my medical insurance and financial situation afforded me an opportunity to go out of town to a recognized cancer center of excellence for the MRI fusion biopsy and the nerve sparing RALP. I'm coming up on 4 weeks after surgery and I'm virtually 100% continent. No idea on ED yet.