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 83-year-old male presents with elevated PSA level measuring 15.7ng/mL. No family history of prostate cancer. Patient was diagnosed with prostate cancer seven years prior and under active surveillance.PRIMARY FINDING:&#160;PI-RADS 5 of 5.FINDINGS: Prostate gland measures 6.5cm in CC, 5.1cm in AP and 6cm in RL dimensions. Calculated prostate volume is 104 and PSA density is 0.15.&#160;Transitional zone hyperplasia is present. Crescentic-shaped T2 hyperintensity measuring 1.9cm in longest dimension is present in the apical transitional zone asymmetric to the right. The lesion demonstrates severe diffusion restriction and early arterial enhancement. Abutment of the anterior capsule with bulging is noted. However, there is no substantive evidence of extracapsular extension. The lesion also abuts the distal prostatic urethra without evidence of wall invasion. Bilateral neurovascular bundles are intact. Generalized T2 hypointensities without mass-like appearance are seen in the peripheral zone. No substantive diffusion restriction or early arterial enhancement on washout to suggest malignant neoplastic process identified.&#160;No enlarged lymph nodes in the obturator regions. No lymphadenopathy in the inguinal regions. A few reactive lymph nodes smaller than 1cm in short axis are noted.&#160;Urinary bladder is full and demonstrates increased trabeculation and a pseudodiverticular formation at the right posterolateral and left lateral aspect.&#160;Rectoprostatic angles are clear.&#160;Bilateral fat-containing inguinal hernias are present.&#160;Moderate degenerative arthritic changes of bilateral hip joints with mild capsulitis. Symphysis pubis is intact. Intrasubstance microtears are seen in the right hamstring origin. The left hamstring origin is intact.&#160;CONCLUSION:&#160;1. PI-RADS 5 of 5, the dominant lesion is in the transitional zone of the apex, asymmetric to the right. Bulging of the anatomical capsule. Extracapsular microinvasion is not excluded. Abutment of the distal prostatic urethra.&#160;2. Urinary bladder is full and demonstrates increased trabeculation and a pseudodiverticula formation at the right posterolateral and left lateral aspect.&#160;3. Fat-containing small inguinal hernias.&#160;4. Moderate degenerative arthritic changes of bilateral hip joints with mild capsulitis.&#160;5. Intrasubstance microtears of the right hamstring origin.</div>

Case

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