I was wondering if anyone has heard of PIRADS 4 and 5 lesions that turned out to be false positives?
Prostate Pre-Biopsy Multiparametric M... - Advanced Prostate...
Prostate Pre-Biopsy Multiparametric MRI False Positives
Yes the tech that was in the room with the Urologist taking my biopsy samples said he had seen Pirad 5 lesions that were negative for PCA. That was not the case for me.
TylexGP,
Thanks very much for your feedback.
The reason I asked that question is that about one month ago my pre-biopsy mpMRI results came back positive with a Pirads 4 and a Pirads 5 lesion.
Ideally, before I commit to a needle biopsy, I would like to repeat the MRI pre-biopsy and then compare the two MRI results to see if the results are reproducible or not (perhaps false positives due to inflammations or other conditions that can masquerade as cancer on the MRI images), or if one or more of the suspicious areas disappears, stays the same, progresses in size, or if any new suspicious lesions pop up. At the same time, I continue to monitor the progression of the PSA.
If anyone else can provide additional data points regarding false positives from pre-biopsy mpMRI scans, that would be greatly appreciated.
Thank you
A friend of mine had mpMRIs and targeted biopsies twice. Both time the biopsy found nothing when the second mpMRI spotted progression. His PSA has been steadily climbing and free to total ratio declining. His urologist tells him there is nothing he can do given a negative biopsy. I am convinced that one day he will be greatly surprized.
Justfor_,
Thanks very much for another data point.
Do you happen to know the specifics of both mpMRI results in terms of Pirads 1,2,3,4, or 5 lesions?
Thank you
The first was PIRADS 3, the second was upgraded to 4. Almost two years between the two.
Justfor_,
Very interesting data point.
Also, do you happen to know approximately his PSAs at the time of his two MRIs?
Thank you
Only sure about the second 11.x. The first should had been somewhere between 9 and 10. I can find out if this is important to you.
There is a side road for you to check before going the biopsy route. Take Avodart for 6 months and if your PSA halves or about then it is the real thing. There is always the PSMA PET, but you will have to pay out of pocket.
Justfor_,
That's good enough. No need to follow up.
I'm not sure what you meant by "I am convinced that one day he will be greatly surprized." You mean you expect him to have cancer some day in the future, even though his biopsy was negative?
Can you please clarify?
I am expecting him finding out about his ongoing cancer some time in the future.
Justfor_,
Thanks for mentioning Avodart. I wasn't aware of such a thing.
I just looked it up, and it's supposed to reduce the size of an enlarged prostate. But, how does that tell you whether or not you have cancer? I must be missing something. Can you perhaps explain?
I beat these bushes after my MRI showed a PIRADS 4. Had a 2nd opinion read from the chair of radiology at a comprehensive cancer center. Same results. Saw three different urologists and all said it could be a false positive but biopsy is the only way to know for sure. Damned if it wasn’t right. 9/12 positive cores mostly 4+5 and 5+4 but 1 was 5+5. I guess I should have bought a lottery ticket.
Greetings plee12,
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Good Luck, Good Health and Good Humor.
j-o-h-n Saturday 03/19/2022 3:08 PM DST
j-o-h-n,
Ok done. Thanks for reminding me.
I am posting this for plee12 since I think it deserves some responses.
Thank you!!!
j-o-h-n
Hello,
Just joined this group a few days and hoping to get some members' insights on my situation.
Here's my situation:
Because of a recent trend of elevated PSA,
Feb 2020 4.3
May 2020 4.9
Nov 5 2020 5.8
Nov 22 2021 6.7
About one month ago I got a multiparametric MRI scan of my prostate
(pre-needle biopsy). The results came back positive
as follows:
1. R1: a 1.8 cm lesion in the right anterior to
posterior transition zone at the base to apex of
the prostate is highly suspicious for prostate cancer
(PI-RADSv2.1 category 5).
2. L1: a 1.0 cm lesion in the left anterior peripheral
zone at the base to mid gland of the prostate is
suspicious for prostate cancer
(PI-RADSv2.1 category 4).
3. L2 L1:0.6 cm lesion in the left posteromedial
peripheral zone at the mid gland and of the prostate
suspicious for prostate cancer
(PI-RADSv2.1 category 4).
However, strangely, it also reported the following:
"The prostate is normal in size measuring 4.7 x 3.3 x 3.6
cm (volume 29 mL)."
Based on the results, my urologist wants me to do
a needle biopsy right away.
Since my prostate size is very normal for my age (69), and
my PSA of 6.7 is still quite reasonable for my age, I'm
questioning the wisdom of doing a needle biopsy at this
time.
Ideally, I would like to wait perhaps 6 months to one year
to repeat the MRI biopsy and then compare the two MRI results
to see if the results are reproducible (perhaps false positives due to
different kinds of inflammations or other conditions that can masquerade
as cancer on the MRI images?), or if one or more of the suspicious areas
disappears, stays the same, progresses in size, or if any new suspicious
lesions pop up. Also, even before repeating the MRI, I continue to monitor
the progression of the PSA.
I think I'm still in a position to buy some more time without
putting myself at risk?
Would appreciate any thoughts on this.
Thank you,
Peter
RSVP
Good Luck, Good Health and Good Humor.
j-o-h-n Saturday 03/19/2022 4:04 PM DST