Recommendation for second opinion on prostate MRI scan?

Posted by merwether @merwether, Jul 18, 2023

Interested in finding radiologist experienced in reading MRI scans of prostate to provide second opinion.
Thanks!

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All MRI’s are not the same. If you can use a multi planner T3 MRI. it’s the best out there. PSMA. Is considered better but you may have to travel to get done Don’t blame you for wanting a second opinion. Radiologist only have 3-4 seconds to read a scan. Too much volume. Scan may not be real clear and bias is always a possibility.

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@philipbrachko

All MRI’s are not the same. If you can use a multi planner T3 MRI. it’s the best out there. PSMA. Is considered better but you may have to travel to get done Don’t blame you for wanting a second opinion. Radiologist only have 3-4 seconds to read a scan. Too much volume. Scan may not be real clear and bias is always a possibility.

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Thanks for your comment. I had a the MRI you described above. State of the art equipment, but yes, I would appreciate any recommendations on second read. From what I understand, the radiologist needs considerable experience in reading prostate scans in order to make reliable interpretation.

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What was the MRI interpretation?
Fusion guided biopsy, utilizing the MRI, would be the next step and more definitive than MRI.

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I had MRI guided biopsy. Diagnosis was 3+4 (10-20% pattern 4). Recommended treatment because volume of pattern 4 had increased from first biopsy two years ago. I had second opinion of second biopsy from J. Hopkins which was interpreted as 3+3. My urologist still recommends treatment because even if JHopkins interpretation of biopsy slide was correct the MRI was interpreted as PIRADS 5 and showed an increase in size of lesion and pushing against capsule wall. PSA is 9.6.
I am leaning to treatment but want second opinion about MRI from someone who specializes in reading prostate scans before proceeding.

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@merwether

I had MRI guided biopsy. Diagnosis was 3+4 (10-20% pattern 4). Recommended treatment because volume of pattern 4 had increased from first biopsy two years ago. I had second opinion of second biopsy from J. Hopkins which was interpreted as 3+3. My urologist still recommends treatment because even if JHopkins interpretation of biopsy slide was correct the MRI was interpreted as PIRADS 5 and showed an increase in size of lesion and pushing against capsule wall. PSA is 9.6.
I am leaning to treatment but want second opinion about MRI from someone who specializes in reading prostate scans before proceeding.

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@merwether, if you'd like to seek a second opinion from Mayo Clinic experts, you can request one here http://mayocl.in/1mtmR63

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@colleenyoung

@merwether, if you'd like to seek a second opinion from Mayo Clinic experts, you can request one here http://mayocl.in/1mtmR63

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Thank you.

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@colleenyoung

@merwether, if you'd like to seek a second opinion from Mayo Clinic experts, you can request one here http://mayocl.in/1mtmR63

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I went to the link you provided and do not see where to request a second opinion on a MRI. Can you provide further details? Thank you.

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@merwether

I had MRI guided biopsy. Diagnosis was 3+4 (10-20% pattern 4). Recommended treatment because volume of pattern 4 had increased from first biopsy two years ago. I had second opinion of second biopsy from J. Hopkins which was interpreted as 3+3. My urologist still recommends treatment because even if JHopkins interpretation of biopsy slide was correct the MRI was interpreted as PIRADS 5 and showed an increase in size of lesion and pushing against capsule wall. PSA is 9.6.
I am leaning to treatment but want second opinion about MRI from someone who specializes in reading prostate scans before proceeding.

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Above all DO NOT let the cancer get outside of your prostate!! If it does, you'll have a lot more to deal with. Once cancer penetrates a nerve in the prostate,for example, it can use it as a highway to exit the gland and go wherever it wants in your body. It seems you need to speedup your decision making process and take action.

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In reply to @merwether "Thank you." + (show)
@merwether

Thank you.

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rockin2047 pointed you in the right direction.
I think the MRI is not very relevant post fusion guided biopsy. And the biopsy was interpreted as cancer; G 6 or 7. And the lesion is threatening the capsule.
As was mine. And I had cells migrate beyond the capsule (extraprostetic extension or EPE) which is bad and was a harbinger of my BCR.

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@michaelcharles

rockin2047 pointed you in the right direction.
I think the MRI is not very relevant post fusion guided biopsy. And the biopsy was interpreted as cancer; G 6 or 7. And the lesion is threatening the capsule.
As was mine. And I had cells migrate beyond the capsule (extraprostetic extension or EPE) which is bad and was a harbinger of my BCR.

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Sorry to hear about your experience and hope you are doing well now. I expect a second opinion response on the MRI before the week is out and if it's confirmatory I proceed with treatment plan immediately.
Could you share what your Gleason score was at time of diagnosis?

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