Prostate adenocarcinoma: PIRADS 5

Case contributed by Dr Ian Bickle

Presentation

Raised PSA, 16. Clinically T2b/ T3 lesion right lobe Any PIRADS 4/5 areas?

Patient Data

Age: 80 years
Gender: Male

Prostate volume 37mls.  PSA density 0.43ng/ml.

1.5 cm focus of low T2 signal posterolaterally in the right peripheral zone at the level of the mid gland. Corresponding b1400 change and ADC restriction (PIRADS 5). Moderate length of capsular abutment and irregularity. 

Diffuse PIRADS 3 changes in the thin residual left peripheral zone.

BPH of the transitional zone.

Normal seminal vesicles. No pelvic lymphadenopathy. No sinister bony lesion.

Annotated image

A matrix of sequences demonstrating the right peripheral PIRADS 5 lesion with and without annotation.

Case Discussion

 Left focal PIRADS 5.  If biopsy-proven tumor, radiological stage, early T3a, N0, Mx.

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