Overall,
prostate adenocarcinoma was found in 60 lesions of the 35 examined patients.
All of them had fusion biopsy performed in targets located in either transition or peripheral zones.
4 of the 35 patients had lesions in both of these zones.
21 of the 60 lesions were located in transitional zone and remaining 39 in peripheral zone.
Location and number of lesions assessed with regard to PI-RADS score are presented in table 1.
Table 1.
Location and PI-RADS score of the lesions with confirmed prostate adeno ca.
PI-RADS
v.
2.0
|
Lesions (n=60)
|
TZ (n=21)
|
PZ (n=39)
|
3
|
9/21 (43%)
|
11/39 (28%)
|
4
|
7/21 (33%)
|
22/39 (56%)
|
5
|
5/21 (24%)
|
6/39 (16%)
|
RL- right lobe
LL - left lobe
BX (-) - mapping/cognitive biopsy performed but negative
DRE (-) - digitel rectal examination performed but negative
Case 1 ( Fig. 1 ,
Fig. 2 ,
Fig. 3 ,
Fig. 4 )
Clinical data:
PSA=10.65 ng/ml; BX (-).
Findings:
Size - 48x36x35mm - vol.
31ml,
PSAD – 0.34
Areas of marked T2 hypointensity with signs of restricted diffusion in DWI and ADC maps.
Lesions:
A. RL,
apical segment,
TZp,
10x8mm,
(PI-RADS 3)
B. RL,
middle segment,
TZa/TZp,
11x7mm,
(PI-RADS 3)
C. RL,
apical segment,
PZpm,
5x5 mm,
with CE (PI-RADS 4)
Specimen:
A. RL,
apical segment,
TZp,
(PI-RADS 3) - GL 3+3; 15% of the volume adeno ca.
Case 2 ( Fig. 5 ,
Fig. 6 ,
Fig. 7 )
Clinical data:
PSA=17.16 ng/ml; DRE (-).
Findings:
Size - vol.
52 ml,
PSAD – 0.33
Areas of marked T2 hypointensity with signs of restricted diffusion in DWI and ADC maps.
Lesions:
A. RL,
apical segment,
TZa,
10x12mm,
(PI-RADS 3)
Specimen:
A.
RL,
apical segment,
TZa,
(PI-RADS 3) - GL 3+4; 50% of the volume adeno ca.
Case 3 ( Fig. 8 ,
Fig. 9 ,
Fig. 10 ,
Fig. 11 )
Clinical data:
PSA=35.28 ng/ml; DRE (-),
BX 3x (-).
Findings:
Size - 79x59x81 mm – vol.
196 ml,
PSAD – 0.18
Areas of marked T2 hypointensity with signs of restricted diffusion in DWI and ADC maps.
Lesions:
A. LL,
middle segment,
TZa,
10x8mm,
with CE (PI-RADS 4)
B. RL,
basal segment,
TZa,
11x9mm,
(PI-RADS 3)
C. LL,
apical segment,
TZp,
13x9 mm,
(PI-RADS 3)
D. RL,
apical segment,
TZp,
9x8mm,
(PI-RADS 3)
Specimen:
B.
RL,
basal segment,
TZp,
(PI-RADS 3) - GL 3+4; 5% of the volume adeno ca.
Case 4 ( Fig. 12 ,
Fig. 13 ,
Fig. 14 ,
Fig. 15 )
Clinical data:
PSA=3.16 ng/ml; DRE (-).
Findings:
Size - vol.
79 ml,
PSAD – 0.04
Areas of marked T2 hypointensity with signs of restricted diffusion in DWI and ADC maps.
Lesions:
A.
LL,
apical segment,
AS/TZa,
13x7 mm,
spreading to the RL,
with CE (PI-RADS 4)
Specimen:
A.
LL,
apical segment,
AS/TZa,
(PI-RADS 4) - GL 3+4; 40% of the volume adeno ca.
Case 5 ( Fig. 16 ,
Fig. 17 )
Clinical data:
PSA=9.5 ng/ml; DRE (-),
BX (-).
Findings:
Size – 53x33x33 mm – vol.
30 ml,
PSAD – 0.3
Areas of marked T2 hypointensity with signs of restricted diffusion in DWI and ADC maps.
Lesions:
A. RL,
basal/middle segment,
AS/TZa,
10x14mm,
(PI-RADS 4)
B. RL,
basal segment,
CZ/PZpl,
7x7mm,
with CE (PI-RADS 3)
C. LL,
basal segment,
TZa,
11x8 mm,
(PI-RADS 3)
Specimen:
A. RL,
basal/middle segment,
AS/TZa,
(PI-RADS 4) - GL 4+5; 50% of the volume adeno ca.
Case 6 ( Fig. 18 ,
Fig. 19 ,
Fig. 20 ,
Fig. 21 )
Clinical data:
PSA=10 ng/ml; DRE (-),
BX 2x (-).
Findings:
Size – vol.
49 ml,
PSAD – 0.2
Areas of marked T2 hypointensity with signs of restricted diffusion in DWI and ADC maps.
Lesions:
A. LL,
apical/middle segment,
AS/TZa,
12x14mm,
(PI-RADS 4)
B. RL,
middle/basal segment,
PZpl,
8x8 mm,
(PI-RADS 3)
C. LL,
basal segment,
PZpl,
7x6 mm,
(PI-RADS 3)
Specimen:
A. LL,
apical/middle segment,
AS/TZa,
(PI-RADS 4) - GL 3+4; 14% of the volume adeno ca.
Case 7 ( Fig. 22 ,
Fig. 23 ,
Fig. 24 )
Clinical data:
PSA=6.6 ng/ml; DRE (-),
Findings:
Size – vol.
33 ml,
PSAD – 0.2
Areas of marked T2 hypointensity with signs of restricted diffusion in DWI and ADC maps
Lesions:
A. RL,
basal segment,
TZa,
12x9mm,
(PI-RADS 4)
B. LL,
middle segment,
PZpl,
6x5 mm,
with CE (PI-RADS 4)
C. LL,
middle segment,
TZp,
6x8 mm,
with CE (PI-RADS 4)
Specimen:
A. RL,
basal segment,
TZa,
(PI-RADS 4)- GL 3+4; 75% of the volume adeno ca.
Case 8 ( Fig. 25 ,
Fig. 26 ,
Fig. 27 ,
Fig. 28 )
Clinical data:
PSA=3.56 ng/ml; DRE (-),
Findings:
Size – 46x38x46 mm - vol.
41 ml,
PSAD – 0.08
Areas of marked T2 hypointensity with signs of restricted diffusion in DWI and ADC maps.
Lesions:
A. RL,
apical segment,
AS/TZa,
7x7mm,
with CE (PI-RADS 4)
B. LL,
middle/basal segment,
PZpm/PZpl/CZ,
10x11 mm,
with CE (PI-RADS 4)
Specimen:
A.
RL,
apical segment,
AS/TZa,
(PI-RADS 4)- GL 3+3; 15% of the volume adeno ca.