mpMRI after biopsy

[bw1963]

How long should it take for your prostate to heal after a biopsy before doing an mpMRI?

[gamma909]

According to what I've read, it takes about 6-8 weeks but I suggest you discuss this with the MD that is scheduling the mpMRI. Med onc set up the mpMRI roughly 6 weeks after my biopsy, although when reviewing these results with my urology onc, he said it's possible that the prostate had not quite "settled down" after the biopsy. So I guess there some different opinions. Good luck.

[bw1963 in reply to gamma909]

Thanks for the response Kurt. The reason I asked is that I had the mpMRI 9 weeks post biopsy. It showed "Large field-of-view images demonstrate multiple enlarged bilateral external iliac chain lymph nodes". My uro was concerned with this. I had an appointment with another uro for a second opinion. He looked at the MRI and stated that they were swollen as a result of the biopsy and were doing what they were supposed to do. He recommended RP with PLND.

[gamma909 in reply to bw1963]

Some of this uncertainty is ultimately what led to me to have RALP (scheduled for October). In my opinion, what the surgeon finds and what the pathology shows will be invaluable in determining exactly what's going on. In my case, the mpMRI shows "possible extracapsular extension" and my Decipher test put me in an "unfavorable/ high risk" category for metastases. I view what the surgeon does as a bit like a football coach in that they have a game plan but will adjust as appropriate during the game itself. For example, my surgeon said that he will sample the lymph nodes, have them analyzed, and then determine whether/if more extensive lymph node removal is required. Similar approach for nerve bundles. Good luck with whatever treatment you choose and I wish you good health.

[bw1963 in reply to gamma909]

Thanks Kurt. I'm scheduled for Sept. 19 as it stands now for Open RP with PNLD.

Good luck to you and thanks for your response.

Bill

[Darryl Partner]

Hi bw1963. Did you and your urologist ever discuss doing a mpMRI before a biopsy?

[AlanMeyer Moderator in reply to Darryl]

As Darryl implies, for anyone considering both MRI and biopsy, there are some good reasons to do the MRI first. One has to do with the issues discussed above about waiting for healing. Another is that an MRI can provide evidence of cancer that can be used to direct the biopsy. In fact, there is a recent technology that, if I understand it correctly, uses a computer to combine images from a recent MRI with real-time ultrasound imaging during the biopsy itself, improving the odds of sampling the most important spots in the prostate.

Talk about this with your urologist before undergoing a biopsy. If he doesn't know how to do the MRI + ultrasound imaging, he's behind the times (says he who has no credentials whatsoever

Alan