Are there imaging signs of extraprostatic extension?
Yes, there is a capsular contact and a small bulge. So extracapsular extension is at least possible.
Findings:
Quality: some movement on sagittal images, does not impair diagnostic confidence
Prostate size: 60 x 47 x 52 mm (CC x AP x ML) ≈ 76 mL, PSA density ≈ 0.06 ng/mL2
Haemorrhage: mild bleeding in the right posterolateral apical peripheral (RA-PZpl) and left posterior transition zone (LM-TZp).
Peripheral zone (PZ): in T2w hypointense focus (≈ 9mm), markedly hyperintense in b1400 and markedly hypointense in ADC with capsular contact (10-15mm) and a small capsular bulge, otherwise diffuse hypointense
Transition zone (TZ): heterogeneity, multiple mostly encapsulated BPH nodules, normal surgical capsule
Neurovascular bundles: symmetric
Seminal vesicles: no signs of invasion
Lymph nodes: oval external iliac lymph nodes (up to 6 mm size, smooth margins)
Pelvic bones: small lesion in the right femoral head very likely bone island, no definite signs of bony metastasis
Sigmoid diverticulosis.
Impression:
A single small lesion in the right apical posterolateral peripheral zone (RA-PZpl), consistent with the histologically proven prostate cancer.
An extraprostatic extension is possible.
MRI putative stage: cT3aNxMx