@edutron
I believe that is what I had that started this whole thing off. First thing after that jump in PSA they did a MRI with and without contrast and found one Lesion PI-RADS 5. The MRI showed nothing has spread (will paste it below) and everything else looked good- except the Lesion. Then they did what they called a Fusion Biopsy which was guided by the MRI to the Lesion. Took 3 samples from Lesion and they were all 3+4=7 and grade group 2. They are the last ones on results above. Then they did 6 more snips on each side and found worse stuff than what the MRI Lesion.

MRI results prior to Biopsy:
Procedure: MRI PROSTATE W AND W/O - MRPROST
Results
EXAM: MRI prostate with and without contrast
HISTORY: Elevated PSA. Elevated PSA (States most recent 4.16, but jumped from 3.24 to 5.3 in a year). Hx BPH. Aquaablation
2024, Urolift 2019. Has not had prostate bx ***Clariscan 20mL@2mL/sec*** -KGB
COMPARISON: None.
TECHNIQUE: Multiplanar, multisequence imaging of the pelvis in accordance with PI-RADS recommendations before and after
the intravenous administration of contrast. Large field-of-view axial T1 images were obtained through the aortic bifurcation. 3D
post-processing was performed using DynaCAD.
CONTRAST: 20 cc Clariscan IV was administered without complication
FINDINGS:
Prostate measurement: 5.7 x 5.0 x 4.9 cm Prostate volume: 68.75 cc PSA: 4.16 ng/mL PSA density: 0.06 ng/mL/cc
Peripheral zone: See below.
Transition zone: No index lesion. Stromal and glandular BPH nodules.
Lesions (PI-RADS 3 or higher):
Lesion # 1: Location: Left posterior peripheral zone extending from the base to the apex Size: 2.4 x 1.3 x 2.6 cm (5.83 cc). T2: T2
hypointense DWI: Marked restricted diffusion DCE: Focal early enhancement, positive Prostate margin: Abuts the capsule without
definite invasion Overall PI-RADS Score: 5/5
Prostatic capsule: Intact.
Neurovascular bundles: Not involved.
Seminal vesicles: Not involved.
Lymph nodes: No lymphadenopathy.
Bones: No acute osseous abnormality.
Other findings: Small fat-containing right inguinal hernia.
IMPRESSION:
1. The prostate gland measures 5.7 x 5.0 x 4.9 cm with volume of 68.75 cc. PSA density is 0.06 NG/mL/CC. 2. Lesion # 1: PIRADS
5 lesion in the left posterior peripheral zone extending from the base to the apex measures 5.83 cc. No frank extracapsular
extension. 3. No pelvic lymphadenopathy.
PI-RADS Category 5: Very high (clinically significant prostate cancer is highly likely to be present).