Assessing the validity of Prostate Imaging Reporting and Data System version 2 (PI- RADS v2) scoring system in diagnosis of peripheral zone prostate cancer 

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Assessing the validity of Prostate Imaging Reporting and Data System version 2 (PI- RADS v2) scoring system in diagnosis of peripheral zone prostate cancer  Eman F. Dola, Osama L. Nakhla, Eman A.SH Genidi  European Journal of Radiology Open  Volume 4, Pages 19-26 (January 2017) DOI: 10.1016/j.ejro.2017.02.001 Copyright © 2017 The Authors Terms and Conditions

Fig. 1 60 Years old male patient with acute retention of urine 2 months ago Relieved after urethral catheter application with Hard palpable prostate showing focal lesion on left lateral lobe with Lost median sulcus on digital rectal examination. His Total PSA=150ng/dl. Axial and coronal T2 WI showing left lateral mid-glandular and basal hypo intense focal lesion with capsular and neuro-vascular bundle invasion (a, b). It shows restricted diffusion hyper intense signal in DWI (c) and hypo-intense signals in ADC maps (d) with ADC values ranging from 0.66–0.72×10−3cm2/s (e). This case was diagnosed as PI-RADS 5. European Journal of Radiology Open 2017 4, 19-26DOI: (10.1016/j.ejro.2017.02.001) Copyright © 2017 The Authors Terms and Conditions

Fig. 1 60 Years old male patient with acute retention of urine 2 months ago Relieved after urethral catheter application with Hard palpable prostate showing focal lesion on left lateral lobe with Lost median sulcus on digital rectal examination. His Total PSA=150ng/dl. Axial and coronal T2 WI showing left lateral mid-glandular and basal hypo intense focal lesion with capsular and neuro-vascular bundle invasion (a, b). It shows restricted diffusion hyper intense signal in DWI (c) and hypo-intense signals in ADC maps (d) with ADC values ranging from 0.66–0.72×10−3cm2/s (e). This case was diagnosed as PI-RADS 5. European Journal of Radiology Open 2017 4, 19-26DOI: (10.1016/j.ejro.2017.02.001) Copyright © 2017 The Authors Terms and Conditions

Fig. 2 78 Years old male patient with urinary obstruction and retention followed by urinary catheterization, Total PSA value >100ng/dl, TRUS guided biopsy pathology shows: prostate carcinoma Gleason grade 4+4 involving 100% of needles core tissue. (a, b) axial T2 WI shows : All the peripheral gland is invaded by hypo-intense soft tissue mass with left lateral and posterior capsular invasion showing macroscopic peri-prostatic fatty tissue infiltration and neuro-vascular bundle invasion. (c) Seminal vesicle central and left lateral invasion with hypo-intense soft tissue mass is also noted. (d) The peripheral gland focal lesions show restricted diffusion seen hyper-intense in diffusion weighted images and hypo-intense in ADC maps. (e) The peripheral gland focal lesions showed positive enhancement in contrast MRI study. This patient was diagnosed as PI-RADS 5. European Journal of Radiology Open 2017 4, 19-26DOI: (10.1016/j.ejro.2017.02.001) Copyright © 2017 The Authors Terms and Conditions

Fig. 2 78 Years old male patient with urinary obstruction and retention followed by urinary catheterization, Total PSA value >100ng/dl, TRUS guided biopsy pathology shows: prostate carcinoma Gleason grade 4+4 involving 100% of needles core tissue. (a, b) axial T2 WI shows : All the peripheral gland is invaded by hypo-intense soft tissue mass with left lateral and posterior capsular invasion showing macroscopic peri-prostatic fatty tissue infiltration and neuro-vascular bundle invasion. (c) Seminal vesicle central and left lateral invasion with hypo-intense soft tissue mass is also noted. (d) The peripheral gland focal lesions show restricted diffusion seen hyper-intense in diffusion weighted images and hypo-intense in ADC maps. (e) The peripheral gland focal lesions showed positive enhancement in contrast MRI study. This patient was diagnosed as PI-RADS 5. European Journal of Radiology Open 2017 4, 19-26DOI: (10.1016/j.ejro.2017.02.001) Copyright © 2017 The Authors Terms and Conditions