Unilateral PIRADS 4 with choline PET

Case contributed by Ian Bickle


Prostate cancer treated with radical radiotherapy in 2015. PSA now rising. PET-CT Choline showed likely left sided prostate local recurrence only. Discussed at Urology MDT who advised a MRI Prostate to assess for salvage options.

Patient Data

Age: 55 years
Gender: Male
Nuclear medicine

Radioisotope uptake in the posterior left peripheral zone of the prostate gland.

Tracer in the urinary bladder.

Prostate volume 23mls.
7mm PIRADS 4 lesion in the posterior left peripheral zone at the mid gland level. 
Diffuse PIRADS 3 elsewhere in the peripheral zones.
Normal seminal vesicles.  No pelvic nodes.  No sinister bone lesion

Annotated image

The template shows with and without annotation the focus in the left peripheral zone identified on the choline PET-CT.

Case Discussion

Choline PET-CT has a limited role in the management of prostate cancer.

Here is an example of it for interest.

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