68-year-old male with prostate cancer. The bilateral hip prostheses create artifacts throughout the exam, particularly on the ADC sequence.PELVIS:PROSTATE:Prostate Size: The prostate measures 5.3 cm in transverse, 2.8 cm in AP, and 4.8 cm in craniocaudal length.Peripheral Zone: In the left mid gland peripheral zone, there is a 5 x 3 mm ADC and T2 hypointense focus suspicious for malignancy (series 801 image 17, series 403 image 304). This dominant lesion extends to the capsule, however no definite capsular extension is seen. Abnormal linear/flame-shaped T2 hypointense signal extending from this region anteriorly and medially (series 801 images 17-18) is intermediate suspicion but concerning for tumor extension.Central Gland: Mild nodular changes of BPH.Seminal Vesicles: No evidence of seminal vesicle invasion.Extracapsular Extension: As above.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BONES, SOFT TISSUES: Artifacts related to the bilateral metallic hip prostheses.OTHER: No significant abnormality noted.
1.Suspicious focus in the mid gland left lateral peripheral zone measuring 5 x 3 mm (PI-RADS 4).2.Abnormal linear/flame-shaped T2 hypointense signal extending from this region anteriorly and medially is intermediate suspicion but concerning for tumor extension (PI-RADS 3).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