What is actually definition if PI-rad -3 ?
MRI: What is actually definition if PI... - Prostate Cancer N...
MRI
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Lesions score 3 would indicate presence of prostate cancer are you on active surveillance...your doctor should be able to guide you as to confirmation and possible treatment
i am on AS... i have been on since dec,,2018 ....biopsy showed 3 cores gleason 6,, pathologist report showed 5% of tissue had less than 5% cancer... all PSA., 4 or less, last PSA was 2.75 2 months ago
If not confident with your doctor a second opinion would not hurt...you seem to be at a stage that if anything progresses you can take action to control.
i had my first biopsy read by 3 different pathologist ..one from here in memphis tn .. the one the doctor uses... then from harvard . the third from epstein from johns hopkins ...he is supposedly the best.... ironically all 3 reports came back different diagnosis ..... only thing they agreed on was it was low grade gleason 6 .... my doctor said was that's all that mattered ... so you can see how i feel about this... everyone 's diagnosis is subjective ... i would always recommend at least 2 opinions ,
I understand your frustration...I tend to do a lot of research myself in order to discuss with my MO....you have to in the end trust a physician you are comfortable with...this site also will give a wealth of info...and tall allen is the best
PIRADS is a scale radiologists use when analyzing an mpMRI to assess the risk of finding clinically significant prostate cancer on a subsequent biopsy.
PIRADS 3 = Intermediate suspicion -the presence of clinically significant cancer is equivocal
Clinically significant cancer is defined on pathology/histology as Gleason score ≥7 (including 3+4 with prominent but not predominant Gleason 4 component), and/or volume ≥0.5cc, and/or extra prostatic extension (EPE).
would a second opinion be advisable on MRI indicating pirads 3 ? also i find it odd that gleason score of 6 in 3 cores with 5% of tissue and less than 5% cancer 18 months ago is showing pirads 3... DO you think this is normal with these number ?
PIRADS 3 is defined by the ratings given by radiologists to different parameters used to rate PIRADS 1-5. Different studies have shown significant cancer rates of 15-30 % for PIRADS 3 MRI visible "lesions". A biopsy is recommended for PIRADS 3 lesions. Simplifying, significant cancer generally defined as Gleason 3+4 or greater, or very high volume Gleason 3+3.
i have had one biopsy i am gleason 6 in 3 cores ....questions is this lesion related to the gleason 6 that i have already been diagnosised with .... this MRI was done so my doctor can do a fusion biopsy
This may be another reason for doing an MRI before any biopsy......removes any confusion about possibly oversampling of one area?
i agreed but my doctor for some reason wanted to do biopsy prior to MRI. he said protocol was biopsy first ..then 18 months later fusion biopsy
also strange my doctor told me they would find something on the MRI ... i guess since he already knew i had 3 cores test positive he would see at least that
Suggest a new Doc!!!! Combined standard biopsy plus fusion biopsy find 25-35% more significant cancer than does standard biopsy. Tell him that FACT and ask again why MRI not performed first???? STUPID!! My Uro didn't fight on this...but I was forced to fight the insurer in order to ahve coverage for the fusion biopsy. My 100 page fact-based appeal won the day!!!
Also, he doesn't know MRI will find something not found with standard biopsy.....stupid statement, if that is what he actually said. Find a 21st century Doc!!
Google PIRADS score.
You can get a _relatively_ better view of your stage in case the mpMRI report contains the tumor ADC (Apparent Diffusion Coefficient). There are many papers trying to establish a correlation between ADC and GS. It is true that there is much overlap amid GS groups, so you probably won't end up with an unequivocal Gleason Score.
Examples (higher ADC -> lower GS):
a) Table 2 of ajronline.org/doi/pdf/10.22...
GS of 6 has an ADC range 0.659 to 1.263
b) Table I of ncbi.nlm.nih.gov/pmc/articl...
GS of 6 shows an ADC of 0.750 +/- 0.162
Note on b): In my anectodal case it was the Min value that correlated well with my final pathology report, NOT the Mean that came much higher. So, I travered all the way from 7-8 at mpMRI, 8 at biopsy and finally 9 at pathology.