Male 65 years old with elevated PSA, evaluate for disease. Biopsy in 2007 was negative. PELVIS:PROSTATE:Prostate Size: 5.6 x 3.9 x 4.6 cmPeripheral Zone: Within the anterior apex is a 10 x 7 mm focus of abnormal T2-weighted and ADC hypointensity. There is no early contrast enhancement associated with this lesion. No additional lesions are identified.Central Gland: Benign prostatic hypertrophy.Seminal Vesicles: No evidence of seminal vesicle invasion.Extracapsular Extension: No evidence of extracapsular extension.BLADDER: No significant abnormality noted.LYMPH NODES: No pelvic lymphadenopathy.BONES, SOFT TISSUES: There is a nonspecific enhancing lesion within the left ischio unchanged in size compared to the CT from 2006.OTHER: No significant abnormality noted.
1.10 x 7 mm focus of signal abnormality in the anterior prostate apex is of intermediate suspicion for prostate adenocarcinoma (PIRADS 3).2.No pelvic lymphadenopathy or evidence of extracapsular extension.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