Case Challenge

Case 1 - History: 64-year-old male presents with elevated PSA

Case 2 - History: 80-year-old male presents with malignant neoplasm of prostate

Case 3 - History: 67-year-old male presents with elevated PSA

Case 4 - History: 65-year-old male presents with an elevated PSA

Case 5 - History: 58-year-old male presents with prostate cancer

Case 6 - History: 62-year-old male presents with prostate cancer

Case 7 - History: 62-year-old male presents with elevated PSA level

Case 8 - History: 71-year-old male presents with elevated PSA level

Case 9 - History: 61-year-old male presents with elevated PSA level

Case 10 - History: 51-year-old male presents with elevated PSA level

Case 11 - History: 68-year-old male presents with enlarged prostate and elevated PSA

Case 12 - History: 82-year-old male presents with malignant neoplasm of the prostate

Case 13- History: 58-year-old male presents with malignant neoplasm of the prostate

Case 14- History: 75-year-old male presents with elevated PSA level

Case 15 - History: 78-year-old male presents with elevated PSA level measuring 5.39 ng/mL

Case 16 - History: 62-year-old male presents with elevated PSA level

Case 17 - History: 78-year-old male presents with elevated PSA level measuring 10.6 ng/mL

Case 18 - History: 64-year-old male presents with elevated PSA of 21.22ng/mL

Case 19 - History: 72-year-old male presents with elevated PSA, biopsy two years ago

Case 20 - History: 64-year-old male presents with increasing PSA following negative biopsy

Case 21 - History: 62-year-old male presents with elevated PSA level measuring 7.08 ng/mL

Case 22 - History: 63-year-old male presents with elevated PSA

Case 23 - History: 87-year-old male presents with prostate cancer, rectal cancer

Case 24 - History: 83-year-old male presents with elevated PSA level measuring 15.7ng/mL

Case 25 - History: 46-year-old male presents with hematospermia for the past 6-7 months

Case 26 - History: 79-year-old male presents with elevated PSA level

Case 27 - History: 66-year-old male presents with elevated PSA

Case 28 - History: 64-year-old male presents with adrenal carcinoma neoplasm

Case 29 - History: 76-year-old male presents with elevated prostate specific antigen

Case 30 - History: 66-year-old male presents with PSA 2.07

Case 31 - History: 50-year-old male presents with elevated PSA of 7.05

Case 32 - History: 66-year-old male presents with elevated PSA, negative biopsy

Case 33 - History: 67-year-old male presents with enlarged prostate

Case 34 - History: 55-year-old male presents with elevated prostate specific antigen

Case 35 - History: 66-year-old male presents with elevated PSA

Case 36 - History: 64-year-old male presents with elevated PSA of 5.1ng/mL

Case 37- History: 67-year-old male presents with elevated PSA level

Case 38 - History: 61-year-old male presents with PSA level of 3.1ng/mL

Case 39 - History: 55-year-old male presents with prostate neoplasm

Case 40 - History: 65-year-old male presents with elevated PSA level measuring 14.99ng/mL

Case 41 - History: 77-year-old male presents with cancer diagnosis

Case 42 - History: 62-year-old male presents with elevated PSA of 37.1ng/mL

Case 43 - History: 74-year-old male presents with prostate neoplasm

Case 44 - History: 58-year-old male presents with malignant prostate cancer

Case 45 - History: 59-year-old male presents with elevated PSA level 5.85ng/mL

Case 46 - History: 61-year-old male. Evaluate prostate cancer.

Course Evaluation

Post-Course Activities

This case challenge is comprised of 46 unique Prostate MRI cases that you can scroll through in our diagnostic web viewer to determine your findings. Quiz yourself and earn CME.

Prostate MRI Cases

<div>HISTORY:&#160;This 78-year-old male presents with elevated PSA level measuring 10.6 ng/mL.&#160;History of positive biopsies three years and one year prior.PRIMARY FINDING:&#160;PI-RADS 4 of 5.FINDINGS:&#160;The prostate gland measures 4.5 cm in CC, 4 cm in AP and 5 cm in RL dimensions.&#160;Calculated prostate volume is 47 cc and PSA density 0.22 ng/mL/cc.Transitional zone hyperplasia is present.&#160;No suspicious T2 hypointense area with substantive diffusion restriction in the transitional zone to suggest malignant neoplastic process.&#160;There is a 1 cm in diameter nodular hypointensity with substantive diffusion restriction and/or early arterial enhancement in the right mid segment posterior peripheral zone (PI-RADS 4 of 5).&#160;The lesion abuts the anatomical prostate capsule without substantive evidence of extracapsular extension.&#160;Micro invasion of the capsule is not excluded.&#160;Bilateral neurovascular bundles and dehydrated seminal vesicles appear clear.Rectum wall and space of Retzius are clear.Urinary bladder is partially full.&#160;Indentation of the enlarged transitional zone to urinary bladder floor is noted.Slightly ectatic distal ureters measuring up to 0.7 cm in diameter.&#160;This finding is stable compared to prior study.No lymphadenopathy in the pelvis or inguinal regions.No free or loculated fluid collections.Musculoskeletal structures are grossly normal.&#160;No abnormal osseous enhancement identified.Small hydrocele is noted at the film edge, stable compared to prior study.CONCLUSION:1. PI-RADS 4 of 5, the lesion is in the right mid segment posterior peripheral zone, stable.&#160;Annual MR imaging surveillance is recommended given prior history of known cancer.2. Slightly ectatic distal ureters measuring up to 0.7 cm in diameter.&#160;This finding is stable compared to prior study.3. Small hydrocele seen at the film edge.&#160;Scrotal ultrasound examination is recommended if it has not been done yet.</div>

Case

Under which PI-RADS score would this case most likely be classified?