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Prostate MR after a positive biopsy result

Case Study
Shnier, Ron, M.D. Symbion Research Clinical Imaging Center Australia

Patient history:

A 65-year-old male with a positive prostate biopsy result underwent an MRI examination at the Symbion Research Clinical Imaging Center in Sydney, Australia.

MR examination:

The examination was performed on Achieva 3.0T using the Endo coil and the SENSE Torso coil  in the dual-coil mode.

Images:

T2-weighted TSE coronal T2-weighted TSE axial T1-weighted TSE axial
T2-weighted TSE coronal
T2-weighted TSE axial
T1-weighted TSE axial

 

The T2-weighted TSE images show a low signal abnormality.

The T1-weighted images enabled assessment of the lymph nodes for disease.

 

DWI with SENSE ADC map
DWI with SENSE
ADC map

 

The DW images and the corresponding ADC map demonstrate a highlighted area of restricted diffusion, suggesting lesion abnormality.

 

CSI and spectroscopy left side Click on image to enlargeCSI and spectroscopy right side Click on image to enlarge
CSI and spectroscopy left side
CSI and spectroscopy right side
Click on image to enlarge
Click on image to enlarge

 

The 3D CSI images show a decrease in the citrate peak in the area of the disease.

 

Diagnosis:

An area of neoplastic change is seen in the left side of the prostate. The area is measured to be 17 mm across and occupies the peripheral zone with an extension from the base of the prostate through the mid zone close to the apex.

 

MRI helped to localize the area of neoplastic change and stage the disease as confined to the gland. The patient was therefore a candidate for radical prostatectomy.

Clinical impact of Endo coil 3.0T:

Compared to 1.5T imaging, 3.0T offers more SNR which can be used to improve image quality and MR spectroscopy.

 

The 3.0T Endo coil gives superb image quality and used in combination with the SENSE Torso coil gives a more homogenous signal around the prostate, as well as better visualization of the anterior prostatic tissue. The combination also enables better visualization of macroscopic spread beyond the prostatic capsule and peri-prostatic lymph nodes.



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May 14, 2009

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Case Study
Achieva 3.0T X-series
Release 2.5
Quasar Dual
3T, Body, endocoil, Prostate
 

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