Prostate MRI Fellowship Practice Cases

Genitourinary (GU)

Prostate/seminal vesicles

Daniel Cornfeld

Stephen J Pomeranz

Gain confidence reading and reporting on Prostate MRI Cases with the Medality Fellowship Certificate Program. Practice using real-world, scrollable cases, earn CME, and receive a Fellowship Certificate™ upon completion!

Case Review

Wk 1, Case 1 - Practice

Wk 1, Case 1 - Review

Wk 1, Case 2 - Practice

Wk 1, Case 2 - Review

Wk 1, Case 3 - Practice

Wk 1, Case 3 - Review

Wk 1, Case 4 - Practice

Wk 1, Case 4 - Review

Wk 1, Case 5 - Practice

Wk 1, Case 5 - Review

Practice Cases

Wk 2, Case 1 - Practice

Wk 2, Case 1 - Review

Wk 2, Case 2 - Practice

Wk 2, Case 2 - Review

Wk 2, Case 3 - Practice

Wk 2, Case 3 - Review

Wk 2, Case 4 - Practice

Wk 2, Case 4 - Review

Wk 2, Case 5 - Practice

Wk 2, Case 5 - Review

Wk 3, Case 1 - Practice

Wk 3, Case 1 - Review

Wk 3, Case 2 - Practice

Wk 3, Case 2 - Review

Wk 3, Case 3 - Practice

Wk 3, Case 3 - Review

Wk 3, Case 4 - Practice

Wk 3, Case 4 - Review

Wk 3, Case 5 - Practice

Wk 3, Case 5 - Review

Wk 4, Case 1 - Practice

Wk 4, Case 1 - Review

Wk 4, Case 2 - Practice

Wk 4, Case 2 - Review

Wk 4, Case 3 - Practice

Wk 4, Case 3 - Review

Wk 4, Case 4 - Practice

Wk 4, Case 4 - Review

Wk 4, Case 5 - Practice

Wk 4, Case 5 - Review

Wk 5, Case 1 - Practice

Wk 5, Case 1 - Review

Wk 5, Case 2 - Practice

Wk 5, Case 2 - Review

Wk 5, Case 3 - Practice

Wk 5, Case 3 - Review

Wk 5, Case 4 - Practice

Wk 5, Case 4 - Review

Wk 5, Case 5 - Practice

Wk 5, Case 5 - Review

Welcome to the Prostate MRI Fellowship Practice Cases course! In this course, you&rsquo;ll be presented with a series of worklists, comprised of 25 essential cases you must review to receive your Fellowship Certificate.

&nbsp;

Access Full Fellowship Certificate Program at Anytime <a href="https://mrionline.com/proficiency/prostate-mri-fellowship-certificate/" style="text-decoration:none">Here</a>.

Prostate MRI Practice Cases

CLINICAL INFORMATION 
HISTORY 
50-year-old with PSA of 4. Benign gland. No obstructive urinary symptoms. 

BIOPSY 
Multiple prior negative systematic biopsies.
 
GENERAL ASSESSMENT 
PROSTATE METRICS 
X: 4.9
Y: 3.5
Z: 3.1
Volume: 27.6 

ZONE ASSESSMENTS 
Peripheral zone: T2 bright. Focal lesion anteriorly as below. 
Transition zone: No suspicious areas of abnormal T2 signal. 
Central zone: Normal  
Stroma: Normal  
Nodes: None.  
Bone marrow: Normal.  
Extracapsular: Normal appearance of the seminal vesicles. Recto-prostatic angles are intact. No  asymmetric soft tissue or enhancement along the course of the neurovascular bundles.  

LESIONS 
LESION 1: PERIPHERAL ZONE: LEFT BASILAR ANTERIOR PERIPHERAL ZONE. 
See Case Review topic for key images of the lesion(s).
SCORES 
Sequence: T2 weighted
Score: 4
Description: Circumscribed, homogenous moderate hypointense focus/mass confined to prostate extension or > 1.5 cm in diameter

Sequence: Diffusion weighted
Score: 4
Description: Focal markedly hypointense on ADC and markedly hyperintense on high b-value DWI

Sequence: Dynamic contrast enhanced
Score: +
Description: Focal, and; earlier than or contemporaneously with enhancement of adjacent normal prostatic tissues, and; corresponds  to suspicious finding on T2W and/or DWI

Total
Score: 5
Description: PIRADS 4: high (clinically significant cancer is likely to be present)

Extracapsular extension: no 
Comment: 1.4 cm. ADC value of 650


Case

Asymmetry or invasion of the neurovascular bundle(s)

Breach of capsule with visible tumor extension

Which of these imaging features used to assess for extraprostatic extension is depicted in this case?