MRI Results: What are the chances the lesion is cancer?

You need to know that there are two biopsy options. The first is MRI guided Transrectal UltraSound (TRUS) biopsy. The second is MRI guided Transperineal biopsy. TRUS which has been around for a long time involves a probe which contains the sampling needles which goes up the rectum and then goes through the rectum wall to access the prostate. The doctor will place some antibiotic gel inside the rectum and the patient must take a Cipro pill prior to the procedure. Shortly before this you must perform an enema at home. How well it is done is very important since there is some risk that some fecal matter could pass through the hole in the rectum wall resulting in an infection/sepsis. MRI guided Transperineal biopsy totally ignores the rectum route. It involves numbing the area between the anus and scrotum. The doctor then (I think) makes a very small incision and with the aid of the MRI, guides the probe directly to the MRI detected spot to take samples. Note that at least 2 Mayo doctors don't even do TRUS anymore. One person on this forum said that more areas of the prostate are accessible with the MRI guided Transperineal biopsy. It is not possible to post a webpage URL, so I will give you the titles of the articles to read as follows: Mayo Clinic Minute: Prostate biopsy technique reduces infection risk (June 13, 2022) and also Ultrasound-guided transperineal prostate biopsy (Nov 05, 2019). I will be consulting with my urologist on Feb 16 about the one spot that the MRI detected and will request a MRI guided Transperineal biopsy along with a whole lot of numbing juice!! Please be sure to connect with the rest of us regarding anything new you have learned. In my case I cancelled my TRUS appointment since they did not offer Transperineal in my area. It's your body, go with what your gut tells you. Knowledge is power.

Jump to this post

An additional biopsy approach is Exact Microultrasound Transperineal biopsy.

You may wish to consider ExoDX urine screen. They suggest deferring biopsy if level less than 15.6.

Jump to this post

Yes, the Dana Farber/BWH Mass general hotel deal is the Longwood Inn (I think) just around the corner and mediocre but very suitable.

Jump to this post

March 6, 2023 I had an ExactVu MicroUltrasound Transperineal Biopsy in one of the major hospitals in Wash, DC. The key word here is "Micro" which makes all the difference between the old ultrasound versus micro. The old operates at a lower megaherz level, but micro uses a higher lever of Mhz producing a much clearer image of the prostate. Read about it using the Search terms "Micro-Ultrasound: A New Approach to Prostate Biopsy". My Tesla 3 MRI had shown only 2 lesions, BUT the Micro US revealed 3 ! Note: a Tesla #3 MRI machine is the most tech-advanced as of now (I think). After my biopsy results came in the urologist ordered up a Decipher test because the MRI indicated the cancer was "prostate confined". Read more at decipherbio dot com. Also, "Genomic Test Helps Estimate Risk of Prostate Cancer Metastasis, Death" at hopkinsmedicine. A Decipher test is covered by Medicare and it took about 4 to 5 weeks to get the results back. Luckily it found me to be Low Risk at 0.37 while 0.45 puts one into the Intermediate Risk category. Therefore, it recommended Active Surveillance (AS) rather than radiation. How much does the ExoDX urine screen test cost as well as the others mentioned on the AARP website? Thanks for your input.

Jump to this post