1x CT/MR Review Report Page 1 of 2 1/31/2012 Exam: MRI of the prostate, January 11, 2012. Technique: Axial T1, T2, diffusion weighted, ADC and dynamic enhanced images. Coronal and sagittal T2 with coronal T1 weighted sequences. Physician report: The prostate gland measures 2.9 x 4.9 x 4.1 cm with a volume of 30.4 cc/grams. The central zone measures 2.5 x 3.6 x 3.4 cm. Heterogeneous appearance of the central gland consistent with age related hyperplasia, the overall size/volume of the gland is within normal limits. Normal linear low signal foci are seen within the posterior peripheral zone on the T2-weighted sequence consistent with collagenous septa. At the posterior left lateral base of the prostate (series 6, image 13 & series 8 image 21) is a nodule with decreased T2 signal measuring 0.9 x 0.8 x 0.6 cm. This appears to be epicentered within the peripheral zone and slightly extends to the central zone and pseudocapsule. No perceivable enhancement or diffusion restriction is seen within this region. The remaining portions of the prostate gland are unremarkable. The capsule appears intact. The neurovascular bundle and anterior fibromuscular stroma has a normal appearance. The periprosthetic soft tissues are intact. The bladder wall has a normal appearance. Normal bone marrow signal seen within the pelvis. No pelvic lymphadenopathy is identified. Limited visualization of the rectal mucosa appears appropriate. Impression 1. Nodule involving the posterior, left lateral base of the prostate as described. Findings are nonspecific with differential considerations being hyperplastic nodule, malignancy or sequela from prostatitis. If biopsy is deemed clinically warranted, routine biopsy with additional focal biopsies focused at this region should be considered. Patient report: The nodule described at the posterior left lateral base of the prostate is a nonspecific finding and could represent benign or malignant conditions. Prostate MRI's primary utilization is to evaluate for extent of biopsy proven disease, not for primary diagnosis/screening, this is due to the diagnostic limitations. Biopsy should not be determined solely on the described finding but on the complete clinical picture and discussed with your caring physician. Thank you for allowing us to assist you in your care. References: Siegelman, E (2004). Body MRI. Philadelphia, Pennsylvania:Elsevier Sanders The British Journal of Radiology, 78 (2005), S103â•fiS111 RadioGraphics 2004; 24:S167â•fiS180 Urol. 2006;8(suppl 1):S4-S10 PO Box 339, Del Mar, CA 92014-0339 Phone: (888) 676-9901 ◦ USRadReview.com Page 2 of 2 This page intentionally left blank. Signed on 1/31/2012 at 3:53 pm. By Dr. Michael Khoury [email protected] PO Box 339, Del Mar, CA 92014-0339 Phone: (888) 676-9901 ◦ USRadReview.com