PIRADS 4 and Focal Hyperplasia Question

[VisualDeadlock]

Hi All,

Long story short, I had a PIRADS 3 upgraded to PIRADS 4 on my MRI. I went in an got a trans-perennial MRI guided fusion biopsy done from my URO. After the procedure my doc even said he made sure to hit my lesions multiple times to ensure thoroughness.

The biopsy report came back and said no HGPIN and no carcinoma. But it did find multiple areas of focal hyperplasia (I guess the early stages of BPH - I am currently 44 years old, and my prostate size is normal, a little on the smaller side).

I think I probably asked this question to my doctor, but I forgot the answer he gave. But, would the multiple patches of focal hyperplaxia explain the PIRADs score reading?

Thanks!

[Tall_Allen]

Yes, it can. PIRADS is just a score the radiologist gives to an area that may look more or less suspicious. There are several different kinds of cell changes that look suspicious on an MRI but may turn out to be nothing when they biopsy the tissue. Also, PIRADS scoring is somewhat of an art - as you suggest, different radiologists can come up with different scores. With the expansion of mpMRIs, many radiologists don't have the expertise to read them. Congratulations on no cancer!

[zeddy54]

Congrats on no cancer!

Out of interest, what is/was your PSA?