Their is of course possibility PIRADS lesion/lesions might be found leading to an MRI fusion biopsy next up. I would expect the MRI is the MpMRI specifically for the prostate. On occasion you hear some urologist that just obtained a regular MRI. Certainly the numbers are concerning but would be helpful in context to have PSA history. The ISOPSA regardless of the MRI results along with your regular PSA jump warrant the biopsy regardless of MRI results. Now the numbers might be concerning but even if you did have cancer those numbers don’t infer how extensive it could be. Even if the ISOPSA infers more aggressive, it does not mean in anyway that it has spread or outside the capsule. Until a biopsy that is only way to definitively determine cancer and Gleason score. Few additional steps if you do move on to the biopsy is the PSMA-PET scan after that with also Decipher test. Plenty of options will be available . Good luck