Going for a Biopsy Now
Sorry, I hope it's not too late to add to this thread.
I too had a MRI (Tesla 3.0 no endorectal coil) performed in an attempt to avoid a biopsy.
History: 62 yr. old with an enlarged prostate of 55.9 cc's, psa over an 18 month span started at 5.14 ended at 5.09, low of 4.82 high of 6.90, negative DRE. manageable urinary function, saw palemetto seems to work for me.
FINDINGS: The prostate is enlarged. It measures 4.8cm in maximum transverse dimemsion, 4.2cm in maximum AP dimension, and 5.3cm in maximum cranial caudal oblique dimension. This results in a volume of 55.9cc's
It has normal appearance and signal intensity on T1 imaging.
On T2 imaging however, there is a loss of the normally bright T2 signal in the peripheral zone, seen posteriorly in the midline. This loss of high signal in the peripheral zone extends just to the right of mid gland level. This area enhances normally on the multiphasic gadolinium enhanced sequences. The capsule is intact here.
The remainder of the prostate demonstrates normal diffusion, and enhancement.
The surrounding soft tissues are normal. Normal bone marrow signal.
IMPRESSIONS: In this patient with elevated PSA, prostatic core needle biopsy is recommended, with attention to the peripheral zone in the midline posteriorly, at the level of the mid gland as described above. The findings here are not specific for malignancy, however targeted of biopsy of this region should be performed.
The loss of T2 signal at the midline seems similar to AKAI's findings, perhaps this is normal? having said that and spending $1280.00 for a MRI, I am going to get a biopsy done and at least now they will be able to target a suspicious area.