For anyone interested this is the full MRI report and I’d be happy to send the images to any doctor on here.
Prostate MRI
PROCEDURE:
MRI PROSTATE WWO CONTRAST 72197
REASON FOR EXAM:
N41.9 hematuria, pelvic pain
COMPARISON:
None
TECHNIQUE:
Multi parametric MRI of the prostate gland performed before and after 10 cc of IV gadolinium contrast. No
contrast waste.
This test is designed to evaluate for clinically significant prostate cancer defined as Gleason 7 are higher including either Gleason 4 + 3, or Gleason 3 + 4 with a significant Gleason 4 component. Patients with Gleason 7 (3+4) cancer without significant Gleason 4 component, Gleason 6 or less prostate cancer are not expected to have significant abnormal imaging findings.
FINDINGS:
RIGHT PERIPHERAL ZONE: No evidence of abnormality or diffusion restriction or abnormal enhancement to suggest clinically significant cancer.
LEFT PERIPHERAL ZONE: Ovoid focus at the lower 3rd peripheral zone measures up to 5 x 3 x 7 mm in largest AP, transverse and craniocaudal dimensions. This demonstrates diffusion restriction and low ADC signal. This does not enhance asymmetrically from the adjacent central gland. No other similar-appearing focus identified.
CENTRAL GLAND: Multiple circumscribed heterogeneous nodules are seen within the central gland most compatible with BPH change (PI-RADS 2-clinically significance cancer is unlikely to be present).
Seminal vesicles: Acutely unremarkable
Adjacent structures/neurovascular bundle: Acutely unremarkable.
Lymph nodes: No adenopathy.
Bones: No obvious suspicious osseous lesions.
Prostate volume: The prostate measures 4.0 x 5.4 x 4.4 cm in largest AP, transverse and craniocaudal dimensions. This corresponds to a volume of 49.76 cc. Calculated maximum expected PSA of 5.97 ng/mL
IMPRESSION:
Suspicious diffusion restricting nodule in the left-sided peripheral zone at the apex. PI-RADS 4
I think a biopsy is an excellent idea. Push for a Perineal one over the Rectal. The perineal can access more areas of the gland and will give you a better idea of what is happening overall - not just in the suspicious area.
Phil