MRI report looks positive for a PI-RADs 5

Hi CB

Difficult to say, biopsy results needed but even if cancer Def looks a low key affair and easy to treat or possibly active surveillance.

But of course, it may not be cancer, fingers crossed for negative biopsy result.

Best wishes 

Steve 

Yes, as Grundo says you'll need the biopsy to confirm either way. However if not benign looks contained.

Hi Chairboy1d4982 I agree with your summary, unlikely to be PCa but I don’t understand the PIRADS 5.  

It’s this section I think that gets the 5.

T2. Hypointensity is seen involving peripheral zone of the prostate on both sides more

conspicuous towards the posterior aspect on T2 weighted images, image 20, 4

DWI. Hypointensity seen on ADC map.

DCE. Evidence of early abnormal enhancement

The DCE - I understand it is how the contrast dye perfuses the prostate. I believe cancers tend to have new blood vessels form around/in them but these can be ‘poorly constructed’ so the dye leaks out quickly hence the early abnormal enhancement and hypointensity. But inflamed non malignant tissue can do the same hence the radiologist noting prostatitis cannot be ruled out. 

https://pmc.ncbi.nlm.nih.gov/articles/PMC6309691/

DWI - hypo-intensity is associated with cancers but also inflammation or post infammation scarring. 

My guess is the radiologist took both of those and scored 5.

I’m certain now that post biopsy my imaging will be used as a care discussion of unusual false positives in the radiology team meeting as I don’t think there’s anything else that says cancer in my scan or my PSA and so on.

On a final note, I found the scan on Airmid app. It’s held back from release on the hospital patient portal and not on system one as used by my GP, not is it on the NHS app. That may be an error and I’ll see if my biopsy shows up there before I get a results appointment.

The hospital portal shows my biopsy is back today but cannot be viewed by me yet. My MRI says I can’t see that either but that was sent to GP next day and although not on my GP patient portal appeared on Airmid straight away. So there’s a chance my biopsy will show up there before I get to see a doctor. If it does, after some thought, I have decided to look. As said I don’t think it’s cancer but if it is then I can attend the appt with questions prepped.