MRI 3T Inflammation Confusion

User

Posted 08 Feb 2015 at 07:03

Hi all

Not yet diagnosed, but this 2nd MRI from 2011 and then this month.

There was also found a Cyst, but the Urologist did not mention as I id not have current report prior, but it seems to have grown since 2011. Cant seem to find any information on this type of Cyst.

The MRI states

"There is an approx 8mm posterior midline basal intraprostatic cyst in keeping with a utricular Cyst"

What does this mean? anyone got any ideas? can it impact or add to inflammation?

As for the MRI, there's more questions than answers. There seems to be small foci (focus) area but could be masked. I read somewhere that lots of sitting which I do in office, when sometimes I feel pressure, can actually increase inflammation.

I note the MRI seems to mention Inflammation as the priority then uses "but may" mask. The Last MRI 4 years ago clearly mentions no tumours...in part this also seems to do same. I have booked for MRI Guided template biopsy in March, so now the agony of waiting starts....Read my profile as its been long road, wish there was more definitive testing.

A question. The MRI of mine states:
"There has been no signify change in T2 or diffusion imaging of gland, However there are now more focal areas of contract enhancement within the PZ at the Apex between 4 & 8 O'clock, midland and 5 & 6 OClock and at Base at 7 & ( oClock. These changes MAY be related to inflammation however they could mask small foci of Gleason 3+4 or significant vol Gleason 3+3. These areas are therefore scored as equivocal for sign decease 3/5. There is no macroscopic extra-capsular tumour evident. There is mild hyperplasia of the TZ - low probability of Sign tumour 2/5.
There is no seminal vesicle timor 2/5 or size sign pelvic lymphadenopathy
CONCLUSION
The PSA is slightly elevated with respect to gland volume (35cc up from 27cc in 2011). Evolving PZ enhancement may relate to inflammation but could also mask sign disease - considered equivocal for timor 3/5. These areas could be targeted at biopsy"

My question is, Equivacol is the grey zone where maybe Gleason 3+3. Here they seem to discuss Inflammation more BUT CAN Mask cancer. Im to have MRI guided biopsy in next weeks for these areas so will know.
I tried to search for inflammation v Cancer but can't find anything as its mainly after biopsy or once diagnosed.

Thx Dean

User

Posted 17 Feb 2015 at 04:55

Update
Had consult with Urologist at MRI Centre. He was very good and thorough. Showed me the MRI comparisons on computer. He explained the white contrast on both 2011 and 2015 as being present, but 2015 was just clearer which he explained could be due to me being better hydrated at time of MRI.
For sure there is inflammation but NO visible tumour which in part is good, but as the white area is present he explained why this "may" mask PCa. I asked why Gleason score 3+3 and 3+4, he said the 3+3 would be if potential UNDER the mask for lion of 4-6mm and the 3+4 is due that 5% of lesion at 1-2mm can be a 4, he said its statistical and based on the contrast white showing greater area.
He agrees that inflammation should be treated first then re MRI. He also recommended to avoid biopsy unless absolutely necessary. He says no urgency as he does not think its aggressive and anything is clearly contained. Also size is good and slightly increased but this can be the points taken, but as PSA is stable then density is higher which also is good thing. The only worry is PSAf but again its boarder line. The cyst is from birth, no inflammation but he said the biopsy may also cause damage here so its best to avoid until we are sure. MRI is just another tool and yes there is contrast area but it is grey area. Cheers Dean

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