Case Challenge

Genitourinary (GU)

Prostate/seminal vesicles

Stephen J Pomeranz

Gain confidence interpreting Prostate MRI Cases with MRI Online. Quiz yourself using real-world, interactive scrollable cases & earn CME!

Case Review

Body

Post-Course Activities

This Power Pack is comprised of 75 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

Case 52 - 64-year-old male presents with adrenal carcinoma neoplasm

<div>HISTORY:&#160;This 64-year-old male presents with adrenal carcinoma neoplasm of prostate diagnosis.&#160;Prostate biopsy left lateral apex Gleason 7 (3+ 4).&#160;Left medial apex microscopic focus of atypical glands.&#160;PSA 5.5.&#160;No surgery.PRIMARY FINDING:&#160;PI-RADS 4.FINDINGS:&#160;The prostate measures 4 cm craniocaudal, 3.2 cm transverse and 2.6 cm AP.&#160;The prolate ellipsoid volume is 17.3 mL.&#160;The PSA density is 0.31 ng/mL per cc.Peripheral zone:Rounded 9 mm left apical peripheral zone posterolaterally (PZpl) marked restricted diffusion consistent with a PI-RADS 4 lesion.&#160;Early enhancement.No other areas of restricted diffusion in the peripheral zone.&#160;Benign 6 x 10 mm nonenhancing cyst of the posterior midline of the peripheral zone.Transition zone:Mild benign prostatic hyperplasia.&#160;No suspicious lesions.Other:Normal seminal vesicles and neurovascular bundles.No suspicious soft tissue or bony lesion.&#160;No lymphadenopathy.CONCLUSION:9 mm PI-RADS 4 lesion in the left peripheral zone posterolaterally at the apex.&#160;(Likert grade 5 out of 5 based on imaging characteristics.)&#160;No other significant lesions.</div>

Case

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