Due to the medical concern and health promotion program very actively in Cambodia, lots of gentlemen more likely suspicious on prostate cancer will refer seeing me at the Urology office. In the past, when we suspected prostate cancer, we only have one method to recommend them; we always introduce them to do prostate tissue biopsy procedure though. Since then, not all the patients get the positive prostate cancer result from the biopsy! It took us really upset for someone who doesn’t have prostate cancer instead of receiving an unnecessary biopsy and consequently suffering very unfair with these complications.
- Rectal pain
- Rectal bleeding
- Bloody urination
- Rare but severe complication – Blood stream infection from the biopsy procedure
Currently, MRI prostate is the essential tool to clarify the patients who need to do the biopsy procedure, and today we will discuss on the MRI prostate result interpretation. When a well-trained radiologist does a report on the MRI prostate, they will always report as a system called “PI-RADS” which stands for “Prostate imaging – reporting and data system”. PI-RADS score will be reported as a value between 1 to 5 varied to level of prostate cancer suspicious which will add a lot of information to both urologist and patient for making the decision altogether. Here are the interpretation methods and possibly chances of positive aggressive prostate cancer biopsy result (Based on literature from US in 2018)
- PI-RADS 1 – Most probably not cancer – 0% chance of aggressive prostate cancer
- PI-RADS 2 – Probably not cancer – 0% chance of aggressive prostate cancer
- PI-RADS 3 – Indeterminate of cancer – 8.9% chance of aggressive prostate cancer
- PI-RADS 4 – Probably cancer – 21.4% chance of aggressive prostate cancer
- PI-RADS 5 – Most probably cancer – 62.7% chance of aggressive prostate cancer
You can see from the data that the biopsy must be recommended for someone who get PI-RADS score at least 3. Anyway, it is just an add on data which need carefully counseling between urologist and patient. Any questions, you can discuss with your trusted urologist, or it would be my honor if you text me. See you in next article!