Hello, due to a PSA elevation of 6.8 ng/ml, he was recommended to undergo an MRI, and these are the results. I am quite worried about him.
The prostate has maximum diameters of 7.3 x 3.7 x 5.5 cm, with an estimated volume of 78 cc. In T1-weighted sequences without intravenous contrast, a slight signal intensity alteration is identified, appearing as faintly hyperintense areas of indeterminate significance, which, in any case, do not correspond to a suspicious lesion.
There are stromal and glandular hyperplasia changes in the transitional zone, appearing broad, predominantly iso- and hyperintense, with an impression on the bladder floor. No focal hypointense areas in T2 are observed that would suggest clinically significant cancer.
The peripheral zone is broad, with moderately heterogeneous signal intensity, highlighting a PI-RADS 3-4 lesion of approximately 8 mm in maximum diameter (measured on the ADC map). It is located in the posteromedial peripheral zone of the prostatic apex and appears as:
- Moderately hyperintense on diffusion-weighted imaging (DWI)
- Markedly hypointense on the ADC map
- Hypointense on T2-weighted imaging
If confirmed, the lesion presents a nodular appearance that may extend beyond the posterior glandular border, potentially corresponding to a focus of extraglandular extension, although the length of contact with the glandular contour is less than 1 cm.
No other suspicious lesions are identified in the rest of the gland.
No pelvic or inguinal adenopathy.
Small, millimetric, indeterminate left mesorectal lymph nodes.
No suspicious bone lesions identified.
Small right sacral root cyst at S2-S3.
Stress bladder.
Small left inguinal fat-containing hernia, medial to the inferior epigastric vessels (likely direct).
CONCLUSION:
- PI-RADS 3-4 lesion in the posteromedial peripheral zone of the prostatic apex.
- If confirmed, there may be a focus of extraglandular extension.
- No evidence of lymph node or bone dissemination on this imaging study.