MRI Explained for Prostate Cancer Results Part2
Summary
MRI Evaluations
Focal Lesions:
Lesions #1:
1. Locations: Left, anterior peripheral zone midgland to base.
2. Size: 10 mm (series 4 image 17), previously 5 mm.
3. T2: Score 4. Heterogeneous moderate hypointensity.
4. DWI/ADC: Score 3. Moderately hyperintense on DWI and markedly hypointense on ADC.
5. Mean: ADC value -0.655 x 10-3 mm2/s.
6. DCE: Positive.
7. Extraprostatic extension: Equivocal. Board capsular contact is present.
8. PI-RADS score: 4. PIRADS 4 High (clinically significant cancer is likely to be present).
9. Neurovascular bundle: Unremarkable
10. Seminal vesicles: Unremarkable.
11. Urinary bladder: Urinary bladder wall thickening, likely sequela of chronic outlet obstruction.
12. Rectum/Colon: There is colonic diverticulosis and increased stool in the colon.
13. Lymph nodes: No pathologically enlarged lymph nodes.
14. Bones: No aggressive osseous lesions.
15. Other: No significant pelvic free fluid. Small fat-containing left inguinal hernia.
1. MRI Evaluations:
Locations: Left, anterior peripheral zone midgland to base.
Excerpt:
The best anatomic detail is on small FOV T2WI.
Below an example of a prostate with minimal BPH (<30 mL entire gland).
From superior to inferior, the gland is commonly divided into 3 levels
(approximate thirds):
2. Size:
Size: 10 mm (series 4 image 17), previously 5 mm.
Excerpt:
What Is the Normal Prostate Size? Age, Growth Patterns, and When to Seek Help
The prostate is a small gland in men, approximately size of a walnut. It produces the fluid for semen. Although prostate growth is a normal part of aging, it can sometimes cause symptoms that interfere with bladder function and daily comfort. Understanding the size of the prostate at different stages of life can help identify what is normal and when further evaluation may be needed.
3. T2:
T2: Score 4. Heterogeneous moderate hypointensity.
Excerpt:
Assessment categories
A combination of imaging findings (T2W, DWI, and dynamic contrast enhancement [DCE]) predicts the probability of a cancer that is clinically significant, which is defined as the presence of any of the following 6:
4. DWI/ADC:
DWI/ADC: Score 3. Moderately hyperintense on DWI and markedly hypointense on ADC.
Excerpt:
Magnetic Resonance Imaging (MRI) has transformed our ability to see inside the human body without invasive procedures. For prostate cancer, certain MRI techniques are exceptionally powerful. Two of the most important are Diffusion-Weighted Imaging (DWI) and its quantitative counterpart, the Apparent Diffusion Coefficient (ADC).
5. Mean ADC:
Mean: ADC value -0.655 x 10-3 mm2/s.
Excerpt:
Apparent Diffusion Coefficient as an Early Prognostic Factor of Response to Treatment with Androgen Deprivation Therapy and Radiotherapy in Patients with Prostate Cancer
Norby
6. DCE:
DCE: Positive.
Excerpt:
Dynamic Contrast-Enhanced (DCE) MRI in Prostate Cancer: Contrast Kinetics and Lesion Assessment
Dynamic Contrast-Enhanced MRI (DCE-MRI) is a powerful imaging sequence that adds a functional dimension to prostate cancer diagnosis. While T2-weighted imaging provides detailed anatomical views and Diffusion-Weighted Imaging (DWI) reveals cellular density, DCE-MRI visualizes tumor vascularity and tissue perfusion. By tracking how a contrast agent moves through the prostate, this technique helps radiologists characterize suspicious lesions, assess their aggressiveness, and improve the accuracy of early detection. When combined with T2 and DWI sequences in a multiparametric MRI (mpMRI) exam, DCE-MRI provides critical information that helps differentiate cancerous tissue from benign conditions.
7. Extraprostatic extension:
Extraprostatic extension: Equivocal Board capsular contact is present.
Excerpt:
Abstract
OBJECTIVE. The objective of our study was to evaluate the relationship between the tumor-capsule contact length, defined as tumor contact length (TCL), and extraprostatic extension (EPE) using the MRI-based TCL measurements and the real TCL measurements from pathology and to determine whether
8. PI-RADS score:
PI-RADS score: 4. PIRADS 4 High (clinically significant cancer is likely to be present).
Excerpt:
High Likelihood, Not Certainty: A PI-RADS 4 score indicates a high likelihood of clinically significant prostate cancer, but it does not guarantee malignancy. The actual risk of clinically significant cancer for PI-RADS 4 lesions typically ranges from 37% to 48%.
9. Neurovascular bundle:
Neurovascular bundle: Unremarkable
Excerpt:
No metastases but neurovascular involvement.
Just got results of PSMA PET scan which pretty much confirmed MRI and biopsy reports. Scan indicates no metastases anywhere. However, as the MRI indicated there is neurovascular involvement. Has anyone had this diagnosis? My husband is a healthy 83. Thanks.
10. Seminal vesicles:
Seminal vesicles: Unremarkable.
Excerpt:
What Is the Seminal Vesicle?
The seminal vesicles—sometimes called the seminal glands or vesicular glands—are part of the reproductive system in people assigned male at birth. They are small glands that produce the majority of the fluid that makes up semen, though they do not have a role in producing sperm. Sperm are produced in the testicles.
11. Urinary bladder:
Urinary bladder: Urinary bladder wall thickening, likely sequela of chronic outlet obstruction.
Excerpt:
Key Takeaways
Bladder wall thickening (BWT) usually happens when there are other bladder issues like cystitis, bladder outlet obstruction, or bladder cancer.
Signs include trouble urinating, cloudy or bloody urine, pain with urination, and pain with sex.
12. Rectum Colon:
Rectum/Colon: There is colonic diverticulosis and increased stool in the colon.
Excerpt:
Understanding Colonic Diverticulosis
What is Colonic Diverticulosis?
Colonic diverticulosis is characterized by the presence of small pouches, known as diverticula, in the wall of the colon. These pouches are typically not inflamed and often do not cause any symptoms. The condition is common, especially in older adults, and is often discovered incidentally during medical examinations.
Causes of Increased Stool in the Colon
Increased stool in the colon can result from several factors, including:
- Diet: A low-fiber diet can lead to harder stools, which may increase pressure in the colon.
- Bowel Habits: Irregular bowel movements can contribute to stool accumulation.
- Hydration: Insufficient fluid intake can result in dry stools, making them harder to pass.
14. Bones:
Bones: No aggressive osseous lesions.
Excerpt:
Bone lesions are areas of bone that are changed or damaged. Infections, fractures, and tumors can cause a bone lesion. Treatment can depend on the cause, but might include medication and surge
15. Other:
Other: No significant pelvic free fluid. Small fat-containing left inguinal hernia.
Excerpt:
Have you ever heard of Pelvic Free Fluid? It may sound like a big medical word, but don’t worry—I’ll explain it simply. Our pelvic area is the lower part of the belly, where we have some very important body parts. Sometimes, a little bit of fluid in the pelvis is okay. But too much fluid can mean there’s a health problem.
Needs to be written
Norby
Needs to be written
Norby