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Dr. Y.
Dr. Y., Urologist
Category: Urology
Satisfied Customers: 20370
Experience:  I am fellowship trained specializing in general urology and reconstructive urology.
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I have an opportunity at short notice targeted (MRI guided)

Customer Question

I have an opportunity at short notice for a targeted (MRI guided) prostate biopsy.
My urologist is out of contact so would appreciate your view on its need.
PSA recent history
Oct 2015 6.1 (free/total ratio 20%)
Jan 2015 9.2 (free/total ratio 15%)
(Mar -2015 multiparametric MRI scan showed three small irregular areas (two described as PI RADS 3 and one as PI RADS3-4)
Oct 2014 10.5
Mar-2014 5.7
Feb 2014 10.0 (free/total ratio 10%)
Given the recent relatively low PSA reading is a targeted biopsy (of the three irregular areas identified by the Mar 2015 MRI scan) likely to add much information about the probability and strength of prostate cancer?
Submitted: 1 year ago.
Category: Urology
Expert:  Dr. Y. replied 1 year ago.

Given the elevated PSA level and the irregular areas on MRI, there is a good chance that a routine biopsy without MRI guidance can detect cancer if it is present. But an MRI guided biopsy will be more precise. If your insurance will cover the MRI guided biopsy then you should go for it. If they won't cover it, then just do the routine biopsy by ultrasound guidance. Hope this helps.