Reason: questioning status of Prostate cancer History: Prostate Cancer, no pathology reports or PSA is available at the time of this study. PELVIS:PROSTATE:Prostate Size: 5.0 x 3.5 x 3.9 cm.Peripheral Zone: There is focus of low T2 (series 401 image 84) and ADC (series 508 image 404) signal at mid base of right peripheral zone. While this is immediately adjacent to central zone, this region is asymmetric, and is intermediate suspicion for malignancy.Central Gland: Large nodule in the transition zone of the prostate gland measuring 2.2 x 2.3 cm that is hypoattenuating on ADC (series 508 image 324) and T2 (series 401 image 70) sequences with early enhancement. There is mild displacement of the intraprostatic urethra towards the right from this lesion. However, the margins of this lesion is well-defined and may represent stromal hyperplastic nodule.Seminal Vesicles: No evidence of seminal vesicle invasion.Extracapsular Extension: No evidence of extracapsular extension.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.2.3 cm early enhancing nodule in the left transition zone as above. This may represent stromal hypoplastic nodule given well-defined margins but remain PI-RADS 2.2.Tiny focus in the right peripheral zone, correlation with PSA or biopsy result is recommended. This lesion is intermediate for malignancy, PI-RADS 3. Consider targeted biopsy or follow-up MRI to ensure stability. PI-RADS™ v2 Assessment Categories:PIRADS 1 – Very low (clinically significant cancer is highly unlikely to be present) PIRADS 2 – Low (clinically significant cancer is unlikely to be present)PIRADS 3 – Intermediate (the presence of clinically significant cancer is equivocal)PIRADS 4 – High (clinically significant cancer is likely to be present) PIRADS 5 – Very high (clinically significant cancer is highly likely to be present)https://www.acr.org/~/media/ACR/Documents/PDF/QualitySafety/Resources/PIRADS/PIRADS%20V2.pdf