mpMRI

[witantric]

Hi all:

How reliable is mpMRI prostate MRI in showing no metasis? My urologist says

very reliable.

Regards,

Witantric

[MyStarburst]

my husbands doc recommended both because he had a high PSA. Thankfully both showed no spread.

Here’s a useful summary:

urologytimes.com/view/psma-...

[Tall_Allen]

mpMRI doesn't show metastases at all. It shows risk of tumors within the prostate.

[OzzieJ]

As I understand it you need other scans such as nuclear bone scan or a PSMA scan to show metastasis. In my case my pre op scans (bone, PSMA) were clear. Then I had a prostatectomy and despite clear margins had a persistent PSA of 0.5 and two pelvic lymph nodes lit up on a subsequent PSMA scan.

So you need additional scans and even then there is a level of uncertainty.

[maley2711]

Perhaps he meant good accuracy for finding PCa located in prostate itself.. and it is, but there is variability in the abilities of different radiologists who read them. For an expert reader, 95% + of all PIRADS 1-2 MRI results show no significant cancer when biopsied. PIRADS 3-5 readings increase odds that there is significant ancer. Unfortunately, there are still significant cancers found in areas that do not show up on mRI....I think because like all scan, MRI detection is limited to tumor sizes larger than a cetain dimension.....so cancers can be missed by MRI..they do not replace biopsies. The size problem also applies to PSMA PET scans, unfortunately !! MRIs are definitely helping urologists find cancers that previously were missed by a man's 1st biopsy session.

[Daveofnj]

MRIs show extracapsular extension, which is probably what the doctor meant.