62-year-old male with prostate cancer and elevation to previous PSA baseline. PSA was 11.83 ng/mL on 11/21/2016 and was 7.4 ng/mL on 9/11/2015. Biopsy from March 2015 showed benign tissue in all 12 cores. PELVIS:PROSTATE:Prostate Size: The prostate measures 5.5 cm in transverse, 4.3 cm in AP, and 5.8 cm in the craniocaudal diameter.Peripheral Zone: No target lesion in the peripheral zone.Central Gland: In the mid gland transitional zone, there are bilateral ADC and T2 hypointense foci with intermediate suspicion for malignancy measuring 2.2 x 1.4 cm on the left (series 403 image 224) and 1.7 x 1.2 cm on the right (series 403 image 244).Seminal Vesicles: No evidence of seminal vesicle invasion.Extracapsular Extension: None.BLADDER: No significant abnormality noted.LYMPH NODES: No pelvic lymphadenopathy.BONES, SOFT TISSUES: Bilateral fat-containing inguinal hernias, and the left inguinal hernia also contains the left anterior bladder wall (series 301 image 65).OTHER: No significant abnormality noted.
1.In the mid gland transitional zone, there are bilateral ADC and T2 hypointense foci with intermediate suspicion for malignancy measuring 2.2 x 1.4 cm on the left and 1.7 x 1.2 cm on the right (PI-RADS 3).2.Fat and bladder containing left inguinal hernia.PI-RADS™ v2 Assessment Categories:PI-RADS 1 – Very low (clinically significant cancer is highly unlikely to be present) PI-RADS 2 – Low (clinically significant cancer is unlikely to be present)PI-RADS 3 – Intermediate (the presence of clinically significant cancer is equivocal)PI-RADS 4 – High (clinically significant cancer is likely to be present) PI-RADS 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