- 69 year-old, BPH gradual
- PSA rise 1.6 → 4.8 ng/dl
- Abnormal digital rectal exam → Biopsy: Gleason 5+4=9
LEFT: T2-weighted image prior to treatment shows large, low-signal mass (yellow oval) on the right crossing midline anteriorly
RIGHT: Color perfusion map shows correspondingly increased perfusion (yellow-green pixels) with washout (red pixels)
Left: T2-weighted image after treatment shows normalization of T2 signal with reappearance of the normal peripheral-transitional zone border.
Right: Color perfusion map shows correspondingly decreased perfusion (blue pixels) consistent with response to treatment.
Example Report (Prior to Therapy) test
No suspicious lymph nodes or bone lesions
Prostate measures 58 gm with mild prostatic hyperplasia
A single suspicious area is identified:
||Bilateral anterior & right posterior
Seminal vesicles and neurovascular bundles appear normal
- Technical quality: excellent
- Large right lesion crosses midline anteriorly and extends to capsule
- Organ-confined disease - no suspicious lymph nodes or bone lesions
Advantage: UCLA Prostate MRI
- Although PSA remains the mainstay of treatment monitoring, MRI can add value when there is concern for residual disease
- Removable table (GE HDxt or Siemens Skyra) allows for imaging after external patient mold is applied for registration with radiation planning.