2 prior negative biopsies. Elevating PSA. PELVIS:PROSTATE:Prostate Size: 4.8 x 3.2 x 5.2 cmPeripheral Zone: Minimal T1-weighted hyperintense blood product in the paramedial mid gland. Mild T2 weighted hypointense linear stranding in the right hemi-prostate.In the anterior left base/mid-gland there is a wedge-shaped region of T2-weighted hypointensity measuring up to 1 cm (series 801/22) with mild associated restricted diffusion (series 604/424), favored to be benign but amenable to TRUS-MRI-guided fusion biopsy.No suspicious dominant/index lesion is evident.Central Gland: In the right apex there is a vague T2-weighted mildly hypointense region of signal abnormality measuring up to 1.0 x 0.9 cm. No associated restricted diffusion. There may be associated early dynamic-contrast enhancement and wash-out (series 1401/973) in this region but this is equivocal. Changes of benign prostatic hyperplasia.Seminal Vesicles: No evidence of seminal vesicle invasion.Extracapsular Extension: No evidence of extracapsular extension.BLADDER: The bladder is partially distended with resulting moderate apparent trabeculation and wall thickening. LYMPH NODES: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Two indeterminate lesions as described above, in the left anterior mid-gland/base peripheral zone and in the right apex near the anterior fibromuscular stroma are somewhat suspicious and are amenable to TRUS-MRI-guided fusion biopsy.2.Changes of benign prostatic hyperplasia.3.Bladder wall trabeculated thickening likely in part due to underdistention.