I had more confidence in multiple opinions from doctors and multiple pathologists, through imaging and test results, than just one MRI opinion. I had a 3T MRI and my urologist was careful to pick a doctor that he had confidence in to read the results properly. The contrast technology is changing pretty quickly to provide better images. AI is already starting to show potential in enhancing image data and utilizing large finite data sets to help a doctor read images (in my opinion our future for collaborative diagnosis...man and AI). If I have BCR at some point in the future, the imaging might include something like Pylarify, a radioactive contrast. Anyway, I did not stop with just imaging and biopsy.

I also had the prolaris test and the decipher test. Two different RO's from two different centers of excellence recommended the Decipher test because its sampling size was larger than Prolaris. All five of the RO's I saw definitively used the decipher test as a guideline to treatment. Both my tests indicated single mode of treatment which was encouraging. I also took the Myrisk genetic test which tests about 50 specific genes, including BRCA 1 & 2 in case I needed to alert my sons or daughter (breast cancer).

I am 70 and was treated with a specific narrow margin radiation machine. I had Pirad 4. Gleason 3+4. One RO suggested AS (no guarantees from DR's that every 3 month testing would catch any possible spread outside the prostate in time so not worth the risk of waiting). One suggested radiation with hormone therapy. The other three radiation only since I had ruled out prostate removal. Imaging is important but your more than valid question, which alludes to MRI accuracy, encouraged me to look for answers in many directions and then collaboratively decide on treatment.