Low PSA, Positve MRI, Negative Biopsy, today High ExoDx, next steps?

Posted by lakeone @lakeone, 3 hours ago

With a 10 year avg PSA of 1.0, a positive MRI in '25 with 2 - pyrad 3 and 1 - pyrad 4 tumors detected, followed by a negative fusion transrectal biopsy in Oct. '25. Today urologist discovered high ExoDX test, 38.46, and suggested another MRI followed by another transrectal biopsy?
Is this the best course of action or is there any suggestions to further biomarker tests or procedures?
Thank you!

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Jeff Marchi | @jeffmarc | 2 hours ago

You could get a PSE Which is more accurate than ExoDx. You should request a Transperennial biopsy. It can reach more of the prostate, and has less chance of infection. Are they using a guided biopsy? How many samples have they taken from the PIRADS 4 lesion.

Here’s a comparison of the tests