Elevated PSA, evaluate for targetable lesion to biopsy PELVIS:PROSTATE:Prostate Size: Measures 4.7 cm in transverse dimension x 3.2 cm in AP dimension x 4.6 cm in craniocaudal dimension. Peripheral Zone: Located in lateral left peripheral zone at mid gland is rounded focus measuring 8 x 7 mm and better depicted on ADC sequence where there is associated decreased signal, corresponding decreased T2 signal and early arterial enhancement also visualized.Situated in left anterior transition zone at level of mid gland and involving lateral aspect of the anterior fibromuscular stroma is a lesion with indistinct borders measuring 1.5 x 1.2 cm and showing low ADC and low T2 signal (image 324 series 403), microextension into adjacent soft tissues suggested (image 16 series 801). Possible associated component seen just posterior also in transition zone on left side (see image 344 series 403), this may be contiguous with 8 mm left lateral peripheral lesion as well. Although definite suspicious postcontrast features are not seen related to this 1.5 cm anterior transition zone lesion, overall appearance and other imaging features are suspicious for malignancy.Additional more linear appearing T2 hypointense foci seen throughout peripheral zones bilaterally, favored to be postinflammatory in etiology or related to scarring. Central Gland: Moderate degree BPH Seminal Vesicles: Unremarkable in appearance Extracapsular Extension: Not seen. BLADDER: Mild circumferential wall thickening likely reflecting chronic changes secondary to long-standing bladder outlet obstruction related to enlarged prostate gland.LYMPH NODES: Subcentimeter right external iliac lymph node, nonspecific.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1. 8 mm left lateral peripheral zone low ADC signal and T2 hypointense focus, suspicious for malignancy.2. Additional 1.5 cm lesion in left anterior prostate gland described above suspicious for transition zone neoplasm involving anterior fibromuscular stroma.