1

Prostate volume:

Cranio-caudal:

Transverse:

cc25

3

4.1

3.9

AP diameter: cm

cm

cm

Scale 1= no disease2= low probability of disease3= equivocal4= high probability of disease5= certain disease

lat

R

med

R

TZ

R

TZ

L

med

L

lat

L

SV 1 1

base 3 2 2 2 2 2

mid 5 3 2 2 3 3

apex 3 2 2 3

sphincter 2 2

Overall score

Report

Indication: Raised PSA. Positive PCA3 test.

Technique: T1, T2, diffusion-weighted and dynamic contrast-enhanced images. Findings: The prostate volume is 25cc.

0.8cc of very likely tumour (5/5) is seen in the R anterolateral peripheral zone at mid gland level. Inferiorly it is at least 6mm short of the sphincter. There is capsular abutment of 1.5cm and there are prominent pericapsular vessels here, but no clear bulge or extracapsular extension. Microscopic breach is considered moderately likely (3/5) given the abutment, but the likelihood partly depends on the grade of tumour.

Much more subtle T2 change and only mild early enhancement in the left peripheral zone at mid gland level and on the right at the apex (up to sphincter) is probably not significant tumour, but should be sampled and scores 3/5.

No evidence of tumour in the transition zone. No seminal vesicle disease and no significant pelvic lymphadenopathy (the largest external iliac node on the right measures 6mm and is ovoid). CONCLUSION: 0.8cc of tumour on the right. Capsular abutment but no clear extracapsular extension seen. Much more subtle change on the left and at the right apex which should be sampled but is much less suspicious.

Please see page 2 of this report for diagrams & representative images.

Dr. Alex Kirkham FRCS, FRCRConsultant Radiologist

Representative images

upper and

lower extent of

disease

R LVesicles

5/5

2contrast axial

T2 axial

contrast axial

diffusion (ADC) axial

T2 coronal

T2 axial

fused T2 coronal

and long b

diffusion (red)

much more

equivocal: 3/5