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

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Wk 1, Case 5 - Practice

Wk 1, Case 5 - Review

Practice Cases

Wk 2, Case 1 - Practice

Wk 2, Case 1 - Review

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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 
67-year-old with rising PSA to 5. Obstructive urinary symptoms 

BIOPSY 
No prior biopsy. 

GENERAL ASSESSMENT 
PROSTATE METRICS 
X: 5.4 
Y: 5.0 
Z: 5.9 
Volume: 82.8 

ZONE ASSESSMENTS 
Peripheral zone: Heterogeneous with streaky areas of decreased T2 signal. Two focal lesions as below. 
Transition zone: Enlarged. Multiple well encapsulated PBH nodules. 
Central zone: Poorly imaged. 1.5 cm midline cyst. 
Stroma: 
Nodes: None 
Bone marrow: Normal 
Extracapsular: Seminal vesicles, regions of the neurovascular bundles, and recto-prostatic angles are normal. 

LESIONS 
LESION 1: 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 and <1.5 cm in greatest dimension 

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

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: 1.4 cm ADC 500

LESION 2: 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 and <1.5 cm in greatest dimension 

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

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: 1.2 cm ADC 700

Case

Which PI-RADS scores should be applied to the multiple focal lesions in this case?