Prostate carcinoma

Clinical History: 
This is a 70 yr old man who presented with change in his PSA levels. It was 4.3 in 2007 and 7.13 in 2010. He was asymptomatic. A biopsy showed a Gleason score of 9 on the right and prostate intraepithelial neoplasia on the left. Both bone scan and CT did not show metastasis.

Diagnosis:
Prostate carcinoma.

MR Technique:
3T (Seimens Verio) with endorectal coil. Image 1: T1 axial (TR/TE 755/11, slice thickness 3 mm, scan time 2 min 5 sec); Image 2: T2 axial (TR/TE 5280/108, slice thickness 3 mm, scan time 1 min 46 sec) Image 3: T2 coronal (TR/TE 5280/108, slice thickness 3 mm, scan time 1 min 14 sec).

Imaging Findings:
The prostate is enlarged. An approximately 1.4 x 1.2 cm focal hypointense lesion is seen in the mid-right peripheral zone at about 7 o’clock. Another 8 mm hypointense lesion is noted in the left peripheral zone at about 5 o’clock. No obvious capsular disruption is appreciated in relation to either of these lesions and thus no evidence of seminal vesicle, neurovascular bundle, or rectoprostatic angle invasion is seen. No evidence of enlarged lymph nodes are present. Minimal T1 hyperintensity in the medial aspect of the mid-right peripheral zone and the posterior midline peripheral zone may represent changes due to the biopsy.