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

MRI prostate/pelvis with and without IV contrast 

Clinical history: PSA 44. Hard gland. Urinary retention. 

Technique: mpMRI of the prostate at 1.5T with DCE, DWI, T2 

Comparison exam: None 

Findings: 
The prostate measures 4.5 x 4.3 x 4.3 cm for a calculated volume of 43 cc. 
There is loss of the normal zonal anatomy. The entire prostate is replaced by low T2 soft  tissue with diffusion restriction in keeping with diffuse replacement of the prostate with  neoplasm. There is invasion into the base of the seminal vesicles bilaterally and also in  the region of the neurovascular bundles bilaterally. Enhancing soft tissue extends into the recto- prostatic angles. These findings are in keeping with extracapsular extension. 
There is adenopathy along both the posterior inferior and anterior superior aspects of the  right pelvic sidewall. The more inferior lymph node measures 1.9 x 1.6 cm. More  superiorly a round lymph node measures 1.4 x 1.4 cm. Nonspecific lymph nodes are seen  along the left pelvic sidewall. No common iliac adenopathy. 

There is a Foley catheter within the bladder. The bladder is decompressed but still likely  thick walled. There is right-sided hydroureter. Evaluation of the bladder wall for neoplasm  is limited given diffuse thickening and decompression. 

A proximal right internal iliac artery aneurysm measures up to 3.5 cm. There is a suspected 1.5 cm metastasis within the L4 vertebral body. 

Impression: 
Diffuse replacement of the prostate with neoplasm with extension into the seminal  vesicles, neurovascular bundle, and recto- prostatic angles. There is right pelvic side wall  lymphadenopathy. Suspected 1.5 cm L4 vertebral 
body metastasis. 
Right-sided hydronephrosis. The bladder is not adequately evaluated due to decompression.


Case

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