That’s interesting. With an 8(4+4), the PSMA PET scan should’ve at least picked that up. (There are other PET scan options if it doesn’t.) And there’s rarely PNI with 6(3+3).
Have you had independent second opinions on your MRI, biopsy, and PSMA? Much of the interpretation of images, scans, and slides is often as much an art as it is a science and dependent on the skill and experience of whoever is doing the reading. It’s good to have an independent set of eyes reviewing the image/scan/biopsy. If insurance will pay for an independent 2nd opinion, I would get it.