Adenocarcinoma of the prostate, preop PSA 6.2, s/p radical prostatectomy in 3/5/12, pT3aN0, Gleason 3+4, surgical margin positive (bladder base) with detectable post-operative PSA, maximum 0.4 with most recent value 0.25. PELVIS:PROSTATE:Prostate Size: Status post prostatectomy.Peripheral Zone: Status post prostatectomy.Central Gland: Status post prostatectomy.Seminal Vesicles: Status post prostatectomy.Extracapsular Extension: Status post prostatectomy.BLADDER: Soft tissue nodularity posterior to the right bladder near the urethral anastomosis with mild T2 increased signal (series 401 image 61) and ADC decreased signal (series 508 image 304) with enhancement of this lesion series 1301 image 1224). The appearance is similar to prior study.LYMPH NODES: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Soft tissue in the right inguinal region likely relates to prior hernia repair.
1.Soft tissue nodularity posterior to the right bladder near the ureteral anastomosis as above. Appearance is similar to prior study. Given the low PSA value, attention on follow-up imaging.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