MRI report

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Can someone help me understand my husband MRI report please?

How serious is this please

His PSA is 4.86

But the MRI report seems indicating high grade cancer and almost entire occupy the prostate?? His biopsy is not until the end of the month! so 3 weeks from now!! Waiting is killing!

He is in othewise very good health condition and 67 and his parents recently passed at age 92 and 94 so I am hoping that he inherited the family long life gene!

PROCEDURE: MRI PROSTATE W WO CONTRAST

HISTORY: Elevated PSA. Most recent PSA 4.86 ng/mL on 10/24/2024.

TECHNIQUE: Multi-parametric 3.0 Tesla MRI was performed using a torso phased-array coil, including multiplanar T2-weighted images, axial T1-weighted images, axial diffusion-weighted images, and volumetric dynamic post-contrast images of the prostate. Axial in-and-opposed-phase gradient-echo T1-weighted images and pre- and post-contrast fat-suppressed gradient-echo T1-weighted images of the entire pelvis were also obtained using the "Prostate with Contrast" protocol.

COMPARISON: None.

FINDINGS:

Prostate size: 4.6 x 3.7 x 3.9 cm for an overall volume of 35 cc. PSA density: 0.14

Tumor localization: Lesion 1 in the transition zone PI-RADS assessment category: 5, Very high probability Appearance on T2-weighted images: 5, lenticular or non-circumscribed, homogeneous, moderately hypointense, and >1.5 cm in greatest dimension, or definite extraprostatic extension/invasive behavior Appearance on diffusion-weighted images: 5, focal markedly hypointense on ADC and markedly hyperintense on high b-value DWI; >=1.5 cm in greatest dimension, or definite extraprostatic extension/invasive behavior. This lesion has a low ADC value of 0.4 Appearance on dynamic post-contrast images: Positive - focal enhancement directly corresponding to the suspicious finding with early or contemporaneous enhancement to normal prostate

Size: 1.8 x 1.2 cm, series 17 image 14 (T2)

Side: Right

Zone: Transition

Level of prostate: Predominantly mid gland (nearly involving the entirety of the anterior transition zone)

Location within transverse plane: Anterior

Extraprostatic extension: Abuts the prostatic capsule

Additional peripheral zone findings: Linear or wedge-areas of decreased signal on T2-weighted imaging with associated diffuse increased perfusion, suggestive of prostatitis. Additional transition zone findings: Enlarged and heterogeneous with circumscribed nodules consistent with benign prostatic hyperplasia.

Extraprostatic extension: None.

Seminal vesicle invasion: None.

Lymph nodes: No pelvic lymphadenopathy.

Osseous structures: No aggressive osseous lesion.

Additional findings: The urinary bladder is unremarkable. There is a 0.6 cm prostatic utricle cyst.

IMPRESSION: * 1.8 x 1.2 cm right anterior predominantly mid gland (nearly involving the entirety of the right anterior transition zone) transition zone lesion, corresponding to an assessment category of PIRADS 5 - Very high (clinically significant cancer is highly likely to be present). This lesion abuts the prostatic capsule with a low ADC values of 0.4 suggestive of a high-grade tumor.

* No lymphadenopathy.

The prostate gland was segmented and the suspicious lesion(s) were annotated on the DynaCAD system for UroNav guidance.

everythingwillbefine 2 months ago in reply to Bluecloud1

I just found out from the nurse that the hospital we are in does not offer brachytherapy. And I did a search and found only a handful hospitals in US that offers this option for prostate. So we will only have surgery or radiotherapy. We will see radiotherapy oncologist in March and see another surgeon in another hospital in March and I will report back. Thank you guys!

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