Anyone else had this?

You might want to find out how many cores were taken, and how many showed cancer being present.

The Biopsy takes samples according to a pattern, so with a "low volume" result might not show disease because it missed. 

I don't think that it is usual for the Biopsy to show disease and the MRI show nothing, but other people will no better. 

In my case, I had a MRI scan which showed a largish lesion, and this was confirmed by a CT scan. Thankfully the bone scan showed no spread there and the CT scan agreed. 

But the time I got the Biopsy the MRI and the CT scan had confirmed that the cancer has just begun to spread outside the prostate but was potentially curable. They knew where it was and where it was going, so the Biopsy was mainly to establish the risk level. In my case that was quite high. 

The Biopsy confirmed the disease in the same place as the 2 scans, so everything lined up. 

In your case there seems to have been a "WTF?" Moment (sorry, couldn't think of a better way of expressing the surprise). I think you marry be looking at other scans to confirm where the heck it actually is. 

Perhaps you could also ask them to tell you exactly how they plan to confirm the actual position of the tumour.

With a low PSA and a Gleason score of 6 you might be offered active surveillance and no immediate treatment.

More knowledgeable people will be along soon.

Another take on it could be that the MRI was showing a false positive which can happen in approximately 29% of cases initially diagnosed as Likert 4.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10069697/

The anterior lesion could have been too small to pick up on the MRI scan.

Hello again SCJ.

I have found an interesting video on Likert 4 MRI and negative subsequent biopsy in that area giving the reasons why this can happen, but more importantly how significant it is for the future.

https://youtu.be/FyuGm_rHOW0?si=kxHDMKBHuKLE2xlC

I hope it reassures you that your doctor is following a sound course of action in your case with Active Surveillance but make sure that you have the regular PSA tests and make a note in the diary to ensure that you have the repeat MRI. You might get a little more information by asking for a copy of the biopsy and MRI reports. From a previous thread of yours you say that you were told you had 1 Likert 3 and 2 Likert 4 anomalies so was something found in the Likert 3 area and where was that? Another question to ask is the size of the anomalies.

Please keep coming back with questions and don't forget that there is help available if you are struggling to cope with the uncertainty.