Increasing PSA. PELVIS:PROSTATE:Prostate Size: 4.5 x 6.4 x 5.9 cm.Peripheral Zone: The peripheral zone is mildly heterogeneous but predominantly T2 weighted hyperintense.In the left apex there is a mildly T2 hypointense 1.1 x 0.8 cm wedge-shaped focus (series 701/60) which is associated with mildly decreased ADC signal intensity (series 904/224). No associated abnormal arterial enhancement.In the right lateral apex there is a 6 mm linear focus of decreased ADC signal intensity (series 904/224) with associated T2 weighted signal hypointensity.Central Gland: Benign prostatic hyperplasia without a discrete suspicious lesion. In the right apex a well-defined nodule bulges the prostate margin, likely a BPH nodule.Seminal Vesicles: No evidence of seminal vesicle invasion.Extracapsular Extension: No evidence of extracapsular tumor extension.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Wedge-shaped region of decreased T2 weighted and ADC signal intensity in the left medial apex peripheral zone measuring 1.1 x 0.8 cm may represent a site of prostatic adenocarcinoma or focal prostatitis. Additional right apex peripheral zone punctate signal abnormality as described above.