Connect
← Return to Not Good News after prostate biospy when MRI didn't look too bad
Discussion
Not Good News after prostate biospy when MRI didn't look too bad
Prostate Cancer | Last Active: 2 hours ago | Replies (140)Comment receiving replies
@brianjarvis
Yes I posted the PSMA results above and the only place that got a score was below and on phone call he called it Grade Group 3, unfavorable and intermediate:
Abdomen/Pelvis: Multifocal increased radiotracer uptake throughout the prostate gland (including the peripheral and transitional zones). Representative lesion in the left transitional zone at base to midgland has a maximum SUV of 11.1 (PET image 306).
The rib didn't give a score as the PA said in note today that "It was a solitary & suggestive of benign lesion" However that is not what was said in the PSMA radiologist report I posted, it hinted that it could be nothing or it could be as stated below::
Focal increased radiotracer uptake in the left posterior fifth rib, which statistically reflects a benign entity such as fibrous dysplasia. Osseous metastasis is not entirely excluded. Recommend continued attention on routine oncologic follow up imaging and then said:
That doesn’t make me feel all that great as radiologist also just said “Osseous metastasis is not entirely excluded. Recommend continued attention on routine oncologic follow up imaging of the rib”
Especially since I have read that the cancer can skip the nodes and likes to go to ribs and spine. PA also didn’t mention all those other baselines SUV.
As you all can tell, I am confused.
Replies to "@brianjarvis Yes I posted the PSMA results above and the only place that got a score..."
Connect
@diverjer There are a number of fluids, tissues, and organs that express PSMA without being prostate cancer, and will show “increased radiotracer uptake” in a PSMA PET scan. A person who is well-trained in reading PSMA PET scans will see these and know there’s a low likelihood of it being prostate cancer.
As Dr. Johnson (of Mayo Clinic) mentions in that presentation I sent you previously, an MRI might see all sorts of lesions (like bone and rib lesions), and not be able to tell whether it’s an old healed break, a sclerotic remnant, a fibrous dysplasia, or prostate cancer.
However, if that suspicious rib area is expressing PSMA and shows “increased radiotracer uptake” (of what SUVmax?????), then the likelihood of it being prostate cancer is higher (which is why they concluded that “Osseous metastasis is not entirely excluded. Recommend continued attention on routine oncologic follow up imaging of the rib.”)
If it were me, I would be confused as well and would ask them to further investigate this. After all, if this is a metastasis (and hopefully it’s not), it would totally change treatment management.