Male 65 years old with elevated psa. Evaluate for lesion suggestive of prostate cancer. PELVIS:PROSTATE:Prostate Size: 4.3 x 3.6 x 3.3 cmPeripheral Zone: There is a 4 x 3 mm focus of signal abnormality in the left mid gland (series 401/105) and a 4 x 4 mm focus in the right mid gland (series 401/104). These lesions are hypointense on T2 weighted images and ADC demonstrate early contrast enhancement.On the right near the transition zone is a focus of signal abnormality that is hypointense on ADC and moderately T2 hypointense (series 508/304) which most likely represents a BPH nodule.Central Gland: Benign prostatic hypertrophy.Seminal Vesicles: No evidence of seminal vesicle invasion.Extracapsular Extension: None.BLADDER: No significant abnormality noted.LYMPH NODES: No pelvic lymphadenopathy.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small periumbilical hernia.
A 4 x 3 mm lesion in the left mid gland and a 4 x 4 millimeter lesion in the right gland are of both of high suspicion for prostate adenocarcinoma. PIRADS 4.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