Case Studies
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1) Radiation Therapy Follow-Up
- 69 year-old, BPH gradual
- PSA rise 1.6 → 4.8 ng/dl
- Abnormal digital rectal exam → Biopsy: Gleason 5+4=9
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2) Small Volume, Low Grade Disease
- 60 year-old
- PSA 3.6
- 5 of 6 right biopsies GS3+3
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3) Active Surveillance Example 1
- (Initial MRI order was for surgical planning)
- 65 year-old
- PSA 3 → 11 over 6 months
- Microfocus of Gleason 3+3
- Initial report : No posterior disease
- Targeted Biopsy consult prompted 2nd look
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4) Example of Change to Nerve Sparing
- 59 year-old
- PSA 4.3
- standard biopsy: 3+3=6 but large volume left
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5) Extracapsular Extension and Seminal Vesicle Invasion by MRI + Spectroscopy and Pathology
- 59 year-old male
- PSA level: 10
- Clinical staging: T1C
- Blind systematic biopsy results: Gleason: 3+4=7 in the Left prostate
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6) Dynamic Contrast-Enhancement for Biochemical Failure
- Elevated PSA after prostatectomy
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7) MR-Guided Targeted Biopsy
- 63 y/o, PSA 8.8 → 13.2 over 5 years
- All systematic biopsies negative
- Hypointense left anterior lesion with restricted diffusion is moderately suspicious, not in biopsy zone
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8) Benign Disease (Infertility)
- Young man presents with infertility (azospermia)
- Workup and medical history otherwise noncontributory
- Muellerian duct remnant in central upper prostate may obstruct ejaculatory ducts
- Left seminal vesicles are atrophic
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