What is the cutting edge of imaging in a high psa differential? pt refuses to have biopsy and psa has been 10-12 over 7 years, but now has psa 15.

Can't force him: Patient seems to have been told hat a definite diag.can only be by biopsy.Imaging will not give definite diagnosis.Free & total PSA would help:High free PSA(above 25%) is usually BPH(enlarged benign prostate).Low freeP more favors cancer:below 15%,below 7% is v. likely cancer >If biopsy is negative for cancer but stays low or is lower,repeat Biopsy. PSA velocity is also a factor but space limited.