Active Surveillance

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Our radiologists lead the way in prostate imaging. We offer the newest techniques to better detect and stage prostate cancer. Call 310-481-7545 to find out more about prostate imaging and treatment options.


  • (Initial MRI order was for surgical planning)
  • 65 year-old
  • PSA 3 → 11 over 6 months
  • Microfocus of Gleason 3+3
  • Initial report : No posterior disease
  • Targeted Biopsy consult prompted 2nd look


Active Surveillance Example 1

LEFT: Axial T2-weighted image shows slightly asymmetric low signal in the anterior base (yellow arrow)

CENTER: Colorized apparent diffusion coefficient (ADC) map: moderately restricted diffusion

RIGHT: Colorized dynamic contrast enhanced (DCE) perfusion map: focal intense enhancement

Perfusion time-intensity curve
Perfusion time-intensity curve: type III (washout) curve is highly suspicious

Example Report Excerpt for Biopsy Flanning

* Findings

Prostate measures 45 gm with mild prostatic hyperplasia. A single suspicious area is identified:

Location Left anterior base 1:00
Size 1.1 cm
Capsule May involve anterior capsule
T2 Asymmetric, ill-defined (4/5)
Diffusion ADC 0.86, highly restricted (4/5)
Perfusion Intense early + washout (5/5)
Overall Suspicion High (4/5)

Seminal vesicles and neurovascular bundles appear normal


  • Gleason 4+4
  • Bone scan: no metatatic disease

Advantage: UCLA Prostate MRI

  • MRI in active surveillance can either provide reassurance that no significant disease is missed, or find suspicious areas (usually anterior) that warrant tissue sampling.
  • K-space sharing dynamic acquisition (in this case, Siemens TWIST) allows for high spatial and temporal resolution in dynamic contrast-enhanced imaging.