I underwent radical robotic prostatectomy just last Monday (May 1st 2023). I feel great and am happy with my prognosis and surgical outocome.

I had a needle biopsy in Dec 2022 that indicated a Gleeson 7 tumor in my left apical region. I quickly opted for prostatectomy given my age (56) and tumor aggressiveness.

My 3T MRI sounded similar to yours, to translate:
T2 = Organ Contained
Hypointense legion = area of interest ( tumor)
Right peripheral zone = location in prostate
No pelvic lymphoadenopathy = no indication of spread to pelvic lymph nodes
Suspicious legions = tumors

Your MRI is describing an organ contained prostatic tumor. That is good news. No indication of localized metastisis.

In my case my MRI was very similar to yours and very accurate.

The curveball for me was this: after removal pathology found my Gleeson 7 (4+3) was actually a Gleeson 9 (4+5). So my inaccuracy was with the needle biopsy.

So tests are just that and can have diagnostic inaccuracies. I was 2 mm away from capsular breach, which would have been game over for me.

My prognosis now is excellent with a PT2N0 pathology stage (pathology confirmed, organ contained, no lymphoadenopathy). So pathology confirmed my MRI, but altered my biopsy Gleeson score. Now I await my 6 week post-op PSA to assess micro-metastatic disease.

My advice to you is to be decisive. Diagnostics can be inaccurate. You really don’t know what you have so long as it is still in your body.

Only you can decide the right course of action for yourself. Just keep in mind that any data they give you from diagnostics could have inaccuracies. Take the data you are given, don’t delay, make your decision, then move swiftly on your goal.

In the end I am glad I made the decision I did. My tests said I had time. I did not. I was perhaps 3-4 months from terminal T4 disease. I was damn lucky.