Indication: R anterior cryo for 12mm 3+4 in April 2014. PSA has risen to 5.2
Technique: T2, diffusion-weighted & dynamic contrast-enhanced images of the prostate.
Findings: The prostate volume is 34cc.
1. A 3-4mm (0.05cc) focus of moderate restriction on the left adjacent to the posterior
midline 8mm above the apex is more conspicuous than in 2013 and shows some
moderate enhancement. It is considered equivocal for significant tumour. The lack of
restriction elsewhere means a score of 2/5 on PIRADS 2.
2. In the left anterior transition zone at mid gland there is slightly more restriction (now
around 0.15cc), centred 6mm from the midline, than in 2013. However, the ADC is little
different and although there is slightly more confluent T2 low signal in the same location
we score 3/5. No evidence of recurrent anterior tumour on the right.
No evidence of seminal vesicle disease or pelvic lymphadenopathy.
Conclusion: The PSA density is moderately increased but there is no evidence of bulky
tumour. However, two areas score 3/5 and might be monitored: we will probably only be
able to be more definitive by assessing change.
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