History of prostate cancer (right apex 2008) status post brachytherapy now with rising PSA. Recent positive left-sided biopsy. Preoperative evaluation prior to laser ablation. PELVIS:PROSTATE:Prostate Size: 4.6 x 4.1 x 3.3 cmPeripheral Zone: There is diffusely heterogeneous low T2 signal throughout the peripheral zone, limiting evaluation. There is susceptibility artifact throughout the prostate related to brachial therapy seeds.Within the left base there is confluent low T2 signal which extends into the transitional zone. This is associated with restricted diffusion (series 604 image 484) as well as early contrast enhancement (series 1501 image 2657). The abnormal signal extends cranially and medially to abut the internal urethral sphincter. Appearance is compatible with tumor.There is an additional focus of low T2 signal in the posterior mid gland (series 801 image 20). This however does not have associated abnormality on the diffusion-weighted and contrast images and is therefore equivocal for an additional site of tumor.Central Gland: Cystic changes related to benign prostatic hypertrophy. There is mild dilatation of the prostatic urethra; correlate with prior TURP.Seminal Vesicles: Unremarkable.Extracapsular Extension: Abnormal signal abuts the superior and posterior aspects of the left peripheral zone capsule, however there is no definite extracapsular extension.BLADDER: No significant abnormality noted.LYMPH NODES: No pelvic lymphadenopathy.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Abnormal signal in the left peripheral zone base compatible with tumor. The abnormal signal abuts the internal urethral sphincter and the capsule wall, but there is no definite extracapsular extension or evidence of metastatic disease.2.Additional small focus of T2 signal abnormality in the mid gland without associated restricted diffusion or contrast enhancement is equivocal for another site of tumor involvement.