Case 12.16

2014 ◽  
pp. 594-595
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Physical Examination ◽  
Signal Intensity ◽  
Posterior Margin ◽  
Peripheral Zone ◽  
Endorectal Coil ◽  
Sagittal Image ◽  
Central Gland ◽  
Routine Physical Examination

61-year-old man with an elevated PSA on routine physical examination Axial (Figure 12.16.1) and sagittal (Figure 12.16.2) T2-weighted FRFSE images obtained with an endorectal coil demonstrate marked enlargement of the central gland of the prostate, which contains numerous heterogeneous nodules of variable signal intensity. The peripheral zone is compressed and difficult to visualize on the axial images, but it can be seen as a thin lip of tissue projecting along the posterior margin of the prostate on the sagittal image....

Case 12.19

2014 ◽  
pp. 601-602
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Prostate Carcinoma ◽  
Signal Intensity ◽  
Peripheral Zone ◽  
High Signal Intensity ◽  
High Signal ◽  
Axial Diffusion ◽  
Diffusion Weighted Images ◽  
Endorectal Coil ◽  
Central Gland ◽  
History Of

62-year-old man with a history of prostate carcinoma (Gleason score 3+3) on ultrasound-guided biopsy Axial T2-weighted FRFSE images (Figure 12.19.1) obtained with an endorectal coil demonstrate a hypointense lesion in the left anterior peripheral zone with probable involvement of the central gland. The lesion shows high signal intensity on axial diffusion-weighted images (b=1,000 s/mm...

Case 12.21

2014 ◽  
pp. 604-605
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Signal Intensity ◽  
Posterior Margin ◽  
Positive Margin ◽  
Robotic Prostatectomy ◽  
Arterial Phase ◽  
The Past ◽  
Endorectal Coil ◽  
The Right ◽  
P 53

53-year-old man who underwent robotic prostatectomy 4 years ago with a small positive margin in the right apex; PSA was initially zero postoperatively, but it has been slowly increasing in the past year Axial (Figure 12.21.1) and sagittal (Figure 12.21.2) T2-weighted FRFSE images obtained with an endorectal coil demonstrate a lobulated mass with mildly increased signal intensity along the right posterior margin of the bladder outlet extending inferiorly into the prostatectomy bed. Axial arterial phase postgadolinium 3D SPGR images (...

Case 12.18

2014 ◽  
pp. 598-600
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Signal Intensity ◽  
Central Zone ◽  
Peripheral Zone ◽  
Arterial Phase ◽  
Endorectal Coil ◽  
Triangular Region ◽  
Recent Diagnosis ◽  
The Right

62-year-old man with a recent diagnosis of prostate cancer; the Gleason score is 7 (3+4) on the left and 6 on the right Axial FRFSE T2-weighted images (Figure 12.18.1) obtained with an endorectal coil demonstrate a triangular region of low signal intensity within the peripheral zone of the prostate centrally. There is more heterogeneous decreased signal intensity in the anterior right peripheral zone and in the central zone. Axial arterial phase postgadolinium 3D SPGR images (...

scholarly journals Signal Intensity of High B-value Diffusion-weighted Imaging for the Detection of Prostate Cancer

2019 ◽  
Author(s):  
A Rezaeian ◽  
M J Tahmasebi Birgani ◽  
N Chegeni ◽  
M Sarkarian ◽  
M Gh Hanafi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Detection ◽  
Signal Intensity ◽  
Peripheral Zone ◽  
B Value ◽  
Diffusion Weighted Images ◽  
High B Value ◽  
Diffusion Weighted ◽  
Central Gland ◽  
Sensitivity Specificity

Background: Diffusion-weighted imaging (DWI) is a main component of multiparametric MRI for prostate cancer detection. Recently, high b value DWI has gained more attention because of its capability for tumor characterization.Objectives: To assess based on histopathological findings of transrectal ultrasound (TRUS)-guided prostate biopsy as a reference, an increase in signal intensity of prostatic lesions in comparison with normal background tissue on high b-value diffusion-weighted images could be a sign of malignancy. Material and Methods: Fifty-three consecutive patients retrospectively included in the study. All patients underwent routine TRUS-guided prostate biopsies involving 12 cores after the magnetic resonance imaging (MRI) examinations. In seventeen patients (n =35 lesions), the prostate cancer was histologically confirmed by TRUS-guided prostate biopsy. The biopsy results of other patients were negative. Signal intensities on the high b-value (1600 s/mm2) images of the peripheral zone, the central gland, and the defined lesions were evaluated using region of interest-based measurements. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for prostate cancer detection using signal intensity of high b value diffusion-weighted images were calculated.Results: In the patients with confirmed prostate cancer, fourteen had visually increased SI on the high b-value images. The SI of lesions for these patients was higher than the SI of peripheral zone (22±18%) or central gland (31±20%). In patients with a negative biopsy, eight had visually increased SI on the high b-value images. The SI of lesions for these patients was 23±21% and 35±18% higher than the SI in the peripheral zone and the central gland, respectively. The sensitivity, specificity, PPV, and NPV for prostate cancer using SI of high b value DWI were 71, 87, 62, and 87 %, respectively.Conclusions: Visually increased SI on the high b-value images can be an indication of malignancy, although some benign lesions also show this increase in signal intensity. 

scholarly journals Diffusion Is Directional: Innovative Diffusion Tensor Imaging to Improve Prostate Cancer Detection

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 563
Author(s):  
Chen Shenhar ◽  
Hadassa Degani ◽  
Yaara Ber ◽  
Jack Baniel ◽  
Shlomit Tamir ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diffusion Tensor Imaging ◽  
Predictive Value ◽  
Breast Imaging ◽  
Normal Tissue ◽  
Diffusion Tensor ◽  
Peripheral Zone ◽  
Predictive Values ◽  
Directional Diffusion ◽  
Central Gland

In the prostate, water diffusion is faster when moving parallel to duct and gland walls than when moving perpendicular to them, but these data are not currently utilized in multiparametric magnetic resonance imaging (mpMRI) for prostate cancer (PCa) detection. Diffusion tensor imaging (DTI) can quantify the directional diffusion of water in tissue and is applied in brain and breast imaging. Our aim was to determine whether DTI may improve PCa detection. We scanned patients undergoing mpMRI for suspected PCa with a DTI sequence. We calculated diffusion metrics from DTI and diffusion weighted imaging (DWI) for suspected lesions and normal-appearing prostate tissue, using specialized software for DTI analysis, and compared predictive values for PCa in targeted biopsies, performed when clinically indicated. DTI scans were performed on 78 patients, 42 underwent biopsy and 16 were diagnosed with PCa. The median age was 62 (IQR 54.4–68.4), and PSA 4.8 (IQR 1.3–10.7) ng/mL. DTI metrics distinguished PCa lesions from normal tissue. The prime diffusion coefficient (λ1) was lower in both peripheral-zone (p < 0.0001) and central-gland (p < 0.0001) cancers, compared to normal tissue. DTI had higher negative and positive predictive values than mpMRI to predict PCa (positive predictive value (PPV) 77.8% (58.6–97.0%), negative predictive value (NPV) 91.7% (80.6–100%) vs. PPV 46.7% (28.8–64.5%), NPV 83.3% (62.3–100%)). We conclude from this pilot study that DTI combined with T2-weighted imaging may have the potential to improve PCa detection without requiring contrast injection.

Case 12.24

2014 ◽  
pp. 610-611
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Physical Examination ◽  
Endorectal Coil ◽  
T2 Weighted Images

50-year-old man with an elevated PSA level and an enlarged prostate on physical examination Axial FSE T2-weighted images (Figure 12.24.1) obtained with an endorectal coil reveal a heterogeneous mass containing cystic and solid components replacing the prostate. Postgadolinium axial 2D SPGR images (...

Case 11.10

2014 ◽  
pp. 546-546
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Physical Examination ◽  
Cystic Lesion ◽  
Pelvic Mass ◽  
Asymptomatic Woman ◽  
Weighted Image ◽  
Routine Physical Examination ◽  
T2 Weighted Images

57-year-old asymptomatic woman with a pelvic mass palpated during routine physical examination Axial fat-suppressed FSE T2-weighted images (Figure 11.10.1) reveal a large cystic lesion in the pelvis, with a partial septation anteriorly. Coronal FSE T2-weighted image (Figure 11.10.2) shows similar findings. An axial FSE T1-weighted image (...

A Case of Congenital Supernumerary Teeth in an Ovine Dental Pad

2017 ◽  
Vol 34 (4) ◽  
pp. 279-281
Author(s):  
Juan Alberto Corbera ◽  
Immaculada Morales ◽  
Sergio Martin ◽  
Alberto Arencibia ◽  
Carlos Gutierrez
Keyword(s):  
Physical Examination ◽  
Rare Case ◽  
Congenital Abnormalities ◽  
Rare Condition ◽  
Congenital Defect ◽  
Supernumerary Teeth ◽  
Routine Physical Examination

A rare case of congenital supernumerary teeth, also known as hyperdontia, observed in a healthy 8-month-old female ewe is presented. The congenital defect consisted of the presence of 2 incisor teeth embedded in the lateral areas of the dental pad. The anomaly was found during a routine physical examination and no other congenital abnormalities were found in the patient. No prior congenital abnormalities had been seen in the herd and the study of possible associated teratogenic factors was inconclusive. To the authors’ knowledge, this ovine odontogenic abnormality has not been described in the literature and appears to be an extraordinarily rare condition.

Location of local recurrence after MRI-guided partial prostate brachytherapy targeting only the peripheral zone: Implications for focal therapy.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 149-149 ◽  
Author(s):  
Konstantin Kovtun ◽  
Tobias Penzkofer ◽  
Neha Agrawal ◽  
Tina Kapur ◽  
Andriy Fedorov ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Local Recurrence ◽  
Central Zone ◽  
Peripheral Zone ◽  
Focal Therapy ◽  
Prostate Brachytherapy ◽  
Local Recurrences ◽  
Endorectal Coil ◽  
Mri Scans ◽  
Mri Guided

149 Background: Prostate cancer local recurrences usually occur at the same site as the dominant primary tumor in patients treated with radiation therapy to the whole gland. We characterized location of local recurrences in patients who were treated with MRI Guided Partial Brachytherapy in which only the peripheral zone was targeted. Methods: We retrospectively reviewed ten patients with initial cT1c, Gleason score 3+4 or less prostate cancer who developed biopsy proven local recurrences and had available imaging after MRI Guided Partial Brachytherapy targeting the peripheral zone from 1998 to 2006. All 10 patients had 1.5T endorectal coil MRI at diagnosis, performed primarily for staging and not for tumor localization, while at recurrence 8 had 3T endorectal coil MRI and 2 had 1.5T endorectal coil MRI. Scans consisted of at least T1 and T2 sequences. Two radiologists (C.T. and T.P.) blinded to clinical data reviewed diagnosis MRI scans together and quantified likelihood of tumor on a 1 to 5 scale in each section of an eight part prostate in both pre-treatment and recurrence scans. Local recurrence was judged to be in the same location as the baseline tumor if at least 50% of the tumor location overlapped. Results: Only 3 of 10 patients had local recurrences at the same location as the baseline tumor with a mean overlap of 64%. 7 of 10 patients had local recurrences at a different location with a mean overlap of 5%. 5 of 10 patients had recurrences in the central zone of the prostate which did not definitively show tumor on review of the initial 1.5T staging scan. Conclusions: After MRI-guided brachytherapy targeting only the peripheral zone in men initially staged with 1.5T MRI, 50% of the local recurrences occurred at the non-targeted central zone, raising the possibility that focal therapy directed only at the dominant tumor will result in increased out-of-field recurrences. Whether the superior ability of modern 3T multiparametric MRI to detect and precisely localize occult prostate cancer foci will reduce this risk is the subject of current study.

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