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

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Practice Cases

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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.

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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 
75 -year-old with PSA of 7. Benign gland. No urinary symptoms. 

BIOPSY 
No prior biopsies. 

GENERAL ASSESSMENT 
PROSTATE METRICS 
X: 3.9
Y: 3.3
Z: 3.9
Volume: 26.1 

ZONE ASSESSMENTS 
Peripheral zone: linear areas of low signal throughout. Focal lesion as below. Focal low signal in the posterior midline without correlative diffusion restriction. 
Transition zone: Heterogeneous appearance. Focal lesion as below. 
Central zone: Normal 
Stroma: Focal lesion as below. 
Nodes: None 
Bone marrow: Normal 
LESIONS 
LESION 1: TRANSITION ZONE : LEFT BASILAR ANTERIOR TRANSITION ZONE 

See Case Review topic for key images of the lesion(s).

SCORES 

Sequence: T2 weighted
Score: 4
Description: Lenticular or noncircumscribed, homogeneous, moderately hypointense, and <1.5 cm in greatest dimension

Sequence: Diffusion weighted
Score: 3
Description: Focal (discrete and different from the background) hypointense on ADC (arrow) and/or focal hyperintense on high b-value DWI; may be markedly hypointense on ADC OR markedly hyperintense on high bvalue DWI, but not both

Sequence: Dynamic contrast enhanced
N/A

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


Extracapsular extension: no 
Comment: ADC 950 1.3 cm

LESION 2: PERIPHERAL ZONE: LEFT MID POSTERIOR LATERAL PERIPHERAL ZONE 
See Case Review topic for key images of the lesion(s).
SCORES 

Sequence: T2 weighted
Score: 5
Description: Circumscribed, homogenous moderate hypointense focus/mass confined to prostate

Sequence: Diffusion weighted
Score: 5
Description: Focal markedly hypointense on ADC and markedly hyperintense on high b-value DWI

Sequence: Dynamic contrast enhanced
N/A

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

Extracapsular extension: no 
Comment: 1.5 cm ADC 950

Case

What is the overall PI-RADS assessment for this case?