Elevated PSA. 3+3 disease identified on outside hospital biopsy. PELVIS:PROSTATE:Prostate Size: 3.2 x 4.5 x 4.0 cm.Peripheral Zone: In the left mid gland there is an ill-defined region of T2 hypointensity measuring up to 1.0 x 0.6 cm (series 801/15), associated with restricted diffusion (series 704/2 24). There is also associated early arterial enhancement on dynamic contrast-enhanced imaging (series 1 401/201 0). On the ADC imaging the signal abnormality appears to extend across the midline and to the base of the seminal vesicles, however there is no abnormal contrast enhancement of the seminal vesicles appreciated. This signal may be artifactual.In the left apex there is a 8 x 9 mm T2 weighted hypointense rounded focus (series 601/52) with possible associated restricted diffusion (series 704/124) but no arterial enhancement.No additional suspicious lesion is identified.Central Gland: Changes of benign prostatic hyperplasia.Seminal Vesicles: Abnormal ADC signal extends to the base of the seminal vesicles without abnormal postcontrast enhancement appreciated. These findings are equivocal for seminal vesicle invasion.Extracapsular Extension: The left mid gland lesion has a broad base of abutment with spicular enhancement outside of the prostatic margin with a discrete enhancing nodule between the adjacent rectum and prostate suspicious for extraprostatic tumor and involvement of the neurovascular bundle.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.0 cm lesion in the left mid gland peripheral zone with suspected extraprostatic tumor extension involving the left neurovascular bundle.Moderately suspicious 9 mm left apex peripheral zone lesion.