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 80-year-old male presents with malignant neoplasm of prostate. PSA level measuring 9.37ng/mL.PRIMARY FINDING:&#160;PI-RADS IV (Potentially PI-RADS V).FINDINGS: Prostate gland measures 5cm in CC, 5.8cm in RL and 4cm in AP dimensions. Calculated prostate volume is 61cc and PSA density is 0.15.&#160;Transitional zone hyperplasia is present. A 1cm by 1.2cm T2 hypointensity with grade 5 diffusion restriction is seen at the left basal segment posterior peripheral zone, which also represents early arterial enhancement (PI-RADS 4). The lesion abuts the prostate capsule without substantive evidence of extracapsular invasion. No substantive evidence of seminal vesicle invasion. Two T2 hypointense regions with diffusion restriction (grade 4-5 diffusion intensity) are seen at the right basal segment anterior and posterior peripheral zone measuring smaller than 1cm in diameter regions (PI-RADS 4). Otherwise, ill-defined linear T2 hypointensities in peripheral zone without substantive evidence of diffusion restriction suggestive of fibrotic changes. Ectopic nodule is seen in the left mid segment peripheral zone. Two focal areas of moderate to severe diffusion restriction in the basal segment transitional zone in the areas of T2 hypointensity with obscured margins (PI-RADS 3).&#160;Bilateral neurovascular bundles are clear.&#160;T2 intermediate signal intensity with T1 slightly hyperintense appearance in the seminal vesicles suggestive of hemorrhagic content.&#160;Urinary bladder is partially flow and demonstrates a 1cm in diameter true diverticula in the anterior aspect. A few tiny lymph nodes are seen in the obturator regions. Multiple, smaller than 1cm in diameter in short axis lymph nodes with fatty hilum are seen in bilateral inguinal regions, benign in imaging characteristics.&#160;Rectal wall is intact.&#160;Metallic susceptibility artifact in the lower lumbar spine suggestive of surgery. Metallic susceptibility artifacts in the scrotum, likely representing clips.&#160;CONCLUSION:&#160;Dominant lesion is a 1cm by 1.2cm T2 hypointensity with grade 5 diffusion restriction at the left basal segment posterior peripheral zone, which also represents early arterial enhancement (PI-RADS 4). Two T2 hypointense regions with diffusion restriction (grade 4-5 diffusion intensity) at the right basal segment anterior and posterior peripheral zone measuring smaller than 1cm in diameter regions (PI-RADS 4).</div>

Case

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