Elevated PSA of 7.22 which led to him undergoing a prostate biopsy by an outside urologist on 7/28/16. His biopsy was found to be negative. PELVIS:PROSTATE:Prostate Size: 4.6 x 3.3 x 4.7 cm.Peripheral Zone: Diffuse dark signal in the left peripheral zone, this may represent prostatitis.Central Gland: ADC low (series 303 image 344) and T2 low (series 201 image 59) focus measuring 1.6 x 1.0 cm in the right transitional zone. There is mild early arterial enhancement with washout. There is invasion of the right prosthetic urethra by this lesion (series 201 image 56).Seminal Vesicles: No evidence of seminal vesicle invasion.Extracapsular Extension: There is probable anterior extracapsular extension (series 201 image 58).BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Large ADC low and T2 low focus in the right transitional zone with invasion of the right prostatic urethra and probable anterior extracapsular extension, PIRADS 5.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