My MRI Report - Opinions

PIRADS 3 is something they usually like to biopsy? There’s a chance it is cancerous.

You could get a PSE test and see if it finds there is cancer in your bloodstream by looking for cancer biomarkers. It is 94% accurate and if it shows you have cancer in your bloodstream, you can definitely get a biopsy.

The doctor will probably prefer to do one, without that test, Because you are at risk.

Very similar to mine.
I had a 1cm lesion (I'm told that anything over 1cm is "a concern").
PI-RADS 3 - which indicates a 60% chance of clinically-significant cancer.

They should use the MRI scan as a guide for doing a biopsy, so they can target the area(s) of concern.

@jeffmarc
I’m not sure who does the PSE test here in Indianapolis.
I also don’t know if insurance covers it, I know they didn’t cover the 4K test.

@peterj116
I am going to have a fusion guided biopsy next month.
So 1cm is the borderline. Seems like the PI-RADS 3 is borderline as well. PI-RADS 3 is not 60% , it’s more like 11%.

So what happened with your situation ?

With a prostate volume of 172cc, you need to know your PSA in order to calculate your PSA Density.

> What is your PSA Density, PSA Doubling Time, PSA Velocity, and % Free PSA? Those numbers will help determine next steps.

PIRADS 2 means that it is unlikely that clinically significant prostate cancer is present.

PIRADS 3 means that there may or may not be clinically significant prostate cancer present.

They’ll likely recommend a biopsy due to the PIRADS 3.

@indyguy My bad. I had to go back & look.
Mine was PI-RADS 4

PI-RADS 3 carries about a 12% risk of clinically significant cancers, PI-RADS 4 about 60%, and PI-RADS 5 about 85%."

Fusion guided is the way to go, because they overlay the MRI scan with the live ultrasound, so they can play Battleship with your prostate.
It's the definitive way to confirm cancer.
I ended up with a prostatectomy a couple of months later.

PI-RADS 3 gives you more treatment options - depending on what the biopsy shows.
Good luck with the biopsy. It's a very strange experience.

@indyguy
Episwitch does the PSE test.

Your doctor can contact them.

Their web site
https://www.94percent.com/

@brianjarvis
My PSA was 5.79, so that means my PSA density is very low even though the urologist never mentioned it.
I did the 4K test a few years ago and my score was pretty low and besides my PSA everything else was good.

@peterj116
Thanks for your reply. How are you doing now ?

@indyguy Pretty good.
Incontinence was pretty bad & Kegels were a complete fail.
So I ended up with an artificial urinary sphincter.
But I'm alive.