MRI before biopsy?
Hi -
I have a PSA of 4.26, free PSA of 13%, an abnormal suspicious DRE, and my father died at 59 of prostate cancer.
My primary care (VA) has referred my to urology, and my appointment is May 13.
Question: Should an MRI come before a biopsy? If so, and the urologist wants to proceed directly to a biopsy, should I try to insist on an MRI first?
I hope this is an appropriate use of this forum.
Thanks to anyone who might want to weigh in.
Hi
. Considering the exam results and family history it is good that you are being proactive in going to see the urologist and in seeking information in preparation for the appointment. It is a great question about the MRI (and absolutely appropriate for this Forum). I want to share with you this article from the Journal of the American Medical Association which states that "National and international guidelines currently recommend that MRI be performed before a decision is made whether to perform a prostate biopsy:" https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2808559. The research discussed in the paper also found that the MRI before the biopsy resulted on fewer biopsies and when a biopsy was then done "detection of fewer Gleason score 6 cancers, and detection of more Gleason score 7 or higher cancers. Considering what this paper notes, it seems that the standard of care is now for the MRI to come first. Hopefully this information can help inform future conversations with your doctor. Hope your appointment goes well and please feel free, if you like, to keep us posted on how you are doing and to ask further questions. Best, Richard (Team Member) Will do. Thank you so much.
