54b - Answer: 63-year-old male presents with prostate cancer
HISTORY:
This 63-year-old male presents with prostate cancer, CyberKnife. Treatment planning.
PRIMARY FINDING:
PI-RADS 2/5.
FINDINGS:
Prostate volume: 4.8 x 3.5 x 5.8cm for a bullet volume of 63.3cc.
Peripheral zone: Heterogeneous signal within the bilateral paramedian peripheral zone with increased T1 signal in the left, mixed signal at the midline and heterogeneously increased T1 signal on the right suggesting combination of hemorrhage/post biopsy change and/or scarring. Neoplasia could be obscured. No suspicious diffusion restricting T2 hypointensity.
Central zone: CZ/TZ hypertrophy protruding into the bladder trigone. No suspicious CZ/TZ lesion.
Bladder: Wall thickening due to outlet obstruction.
Seminal vesicles: Normal.
Rectoprostatic angles: Normal.
Space of Retzius: Normal.
Lymphadenopathy: None.
Bone lesions: None.
Other: Hydrogel between the rectum and prostate. Good separation of the rectum from the prostate by this hydrogel application.
Small scrotal hydroceles. Bilateral femoroacetabular arthropathy. Large pseudocysts and acetabular spurs on the right. Extensive bilateral labral tearing.
CONCLUSION:
1. PI-RADS 2/5: Heterogeneous signal in the peripheral zone likely post therapeutic, neoplasia could be obscured by combination of hemorrhage and postprocedural change. BPH and bladder wall thickening compatible with outlet obstruction.
2. Hydrogel application resulting in good separation between the rectum and prostate. Separation ranges between 1.1 and 2.0cm.
3. Bilateral femoroacetabular arthropathy.
4. Small scrotal hydroceles.
Case Challenge: Prostate MRI Cases
Case Challenge
Browse other topics in...
Content reviewed: October 25, 2021