Extracapsular Extension and Seminal Vesicle Invasion
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History
- 59 year-old male.
- PSA level: 10
- Clinical staging: T1C
- Blind systematic biopsy results: Gleason: 3+4=7 in the Left prostate
Imaging
LEFT: Axial T2-weighted image: low signal bulges the capsule (arrow)
RIGHT: Gray-scale apparent diffusion coefficient (ADC) map: focal restricted diffusion (arrow)
LEFT: Coronal T2-weighted image: abnormal signal extends to seminal vesicles (arrow)
RIGHT: Sample spectrum from spectroscopic imaging: elevated choline (Cho) relative to citrate (Ci)
Results
- Gleason Score 3+4 prostate cancer
- Extra-capsular extension,
- Left seminal vesicle invasion.
- TNM staging : T3b
Advantage: UCLA Prostate MRI
For patients at intermediate risk of T3 disease, MRI can stratify risk.