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Help me to understand my prostate MRI Report
PSA is 3 (normal range is (0 to 4). I just turned 76 yrs old. Is the lesion described below small medium or large?
Please explain the following terms or phrases.
History: Nodular prostate without urinary obstruction.
Findings:
Prostate measurement 4.1 cm in transverse diameter x 2.9 cm in AP diameter x 4.0 cm in SI diameter.
Transition Zone (TZ) hypertrophy: Present
Peripheral Zone (PZ): Chronic inflammatory changes: Scattered low linear T2 signal in keeping with chronic inflammatory changes.
Enlarged lymph nodes: no pelvic (ie none).
Osseous lesions pelvis: No aggressive abnormality.
Additional findings: Thickened trabeculated bladder.
Prostate volume: 28cc
Lesions:
ROI 1 (report on image 1)
Location: Right mid peripheral zone
Lesion volume: 0.33 cc
Dimensions: 1.3 x 0.5 cm
Axial T2-weighted images: 12 - 14
Pirads v2: (prostate imaging reporting and data system)
T2-weighted images (1-5): 4
ADC (1-5): 4
IMPRESSION:
Right mid peripheral zone lesion measuring 1.3 x 0.5 cm, PI-RADS 4 - High (clinically significant cancer is highly likely to be present).
Right apical peripheral zone lesion measuring 1.0 x 0.6 cm, PI-RADS 1-Very Low (clinically significant cancer is highly unlikely to be present).
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HugInterested in more discussions like this? Go to the Prostate Cancer Support Group.
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@rockin2047, it looks like you've had a chance to see the results of your MRI on the patient portal before being able to discuss them with your cancer team. While fellow members can explain some of the terms or you can Google them, remember that the result of the MRI is only one piece of the diagnostic process. Your cancer team will put all the pieces together to give you a proper diagnosis.
I think you'll find this related discussion that @gefears42 started a few days ago to be reassuring and helpful. He, too, is going through this process at the same time.
- MRI Results: What are the chances the lesion is cancer? https://connect.mayoclinic.org/discussion/mri-results-3/
From what you shared in the other discussion you started,
- Prostate transrectal biopsy https://connect.mayoclinic.org/discussion/prostate-transrectal-biopsy/
The MRI suggest a small lesion with a high probability of cancer and a second one thought to be benign. This MRI will help guide the biopsy you're having this week. I will be thinking of you.
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Hug
3 ReactionsPeripheral Zone: Patchy low T2 weighted areas without significant
restricted diffusion or abnormal enhancement. Findings are due to sequela
of infectious or inflammatory disease most likely.
What does this mean?
Nobody here is doctor, so it would not be prudent for any of us to offer interpenetration - however, that T2 area points to presence of inflammation. (that is what is literary written - this is not interpenetration). I hope your doctor will soon be in contact with you and go over ALL those findings.
Just a layman here, but sequela of infection/ inflammatory disease indicates that what he is seeing on MRI is more suggestive of a previous prostatitis or infection - not a malignancy.
Again, I am just translating the statement you present.
Phil
@rockin2047 My 1st recommendation ., Go out and purchase Dr. Patrick Walsh's book : " Guide to Surviving Prostate Cancer " and start educating yourself on prostate cancer . This book describes : The tests , what they mean , and the treatment options based on certain test scores . Plus go on-line and follow Dr. Mark Scholz U - Tube Videos . You will have to become your own best health advocate .
A CAUTION : If you have a Biopsy , preferably a TRANSPERINEAL MRI Fusion Biopsy , and yor receivee your results - " THE GLEASON SCORE ". Get a 2nd or 3rd opinion to confirm the Gleason Score . Many treatment options are based on the accuracy of this score .
@thaxterstill55, what led to you getting an MRI? When is your appointment to discuss these finding with your doctor?
Thanks for the translation. That agrees with other research I have done. I follow up with my Urologist tomorrow.
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Hug
1 ReactionPSA was elevated since last check six months ago. Overall MRI findings seem favorable but I’ll know more after my follow up visit with my Urologist tomorrow. Thanks,
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Hug
1 ReactionEXAM: MRI OUTSIDE FILM REVIEW
INDICATION: Elevated PSA
PSA: 11 ng/mL
PSA density: 0.53 ng/mL-cc
TECHNIQUE: Multiplanar, multisequential MRI of the prostate was performed at outside institution was submitted for second opinion interpretation.
COMPARISON: None.
FINDINGS:
The prostate volume is 21 cc.
Status post TURP. Axial T1-weighted images demonstrate no hemorrhage, lymphadenopathy or focal bone marrow abnormality.
T2 hypointense lesions seen are described below:
Lesion #1: Well-defined T2 hyperintense lesion extending from the left base peripheral zone towards the posterior apex..
Size: The lesion is largest at the base measuring 1.6 x 1.4 cm. (Series 3 image 11). The lesion measures 2.5 cm in craniocaudal dimension.
DWI:
ADC: Restriction.
High b-value images: Bright signal
DCE: Focal Enhancement
PI-RADS 5
Lesion #2: Ill-defined T2 hyperintense lesion in the right lateral peripheral zone extending from the mid gland to apex.
Size: Lesion measures 1 x 0.3 cm in cross-sectional dimension. (Series 3 image 12).
DWI:
ADC: Restriction.
High b-value images: Bright signal
DCE: Focal Enhancement
PI-RADS 4
No extraprostatic extension and the extracapsular fat is intact. The seminal vesicles are unremarkable.
IMPRESSION:
1. PI-RADS 5 lesion in the left peripheral zone extending from the base to apex.
2. PI-RADS 4 lesion in the right lateral peripheral zone extending from the mid gland to apex.
3. No pelvic lymphadenopathy.
(This was at the beginning of my previous post, but I mistakenly neglected to put it in. Sorry. jEs860
I'm on needles and pins and hoping to hear a reply soon. As I'm sure you can imagine, it's very nerve-racking.