Prostate cancer - unilateral PIRADS 4

Case contributed by Ian Bickle


PSA 3.36. DRE benign. Are there any areas to target at biopsy?

Patient Data

Age: 70 years
Gender: Male

Prostate volume 82 mls.   PSA density 0.04ng/ml.
9 mm PIRADS 4 lesion in the left peripheral zone at the apex. 
Extensive BPH.
Normal seminal vesicles.  No pelvic nodes.  No bone lesions.
Sigmoid diverticulosis.

Case Discussion

A very convincing small PIRADS 4 focus (remember these are no different from PIRADS 5 in terms of imaging appearance only size).

If this lesion was more than 1.5 cm it would be a PIRADS 5.

It is surrounding by a completely normal peripheral zone.

As with the vast majority of the demographic undergoing prostate MRI, there is considerable BPH.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.