MRI Results - 8/12/2016
Patient is status post radical prostatectomy. There is no evidence of abnormal T2 signal mass, restriction or enhancement in the prostatectomy bed.
Seminal vesicles: Normal.
Bladder: Concentric wall thickening with trabeculations suggestive of chronic bladder outlet obstruction.
Lymphadenopathy: No significant lymphadenopathy by size criteria.
Bones: Marked heterogeneous bone marrow signal intensity which limits evaluation for metastases. T2 hyperintense focus in the left sacrum measuring 1.7 cm. In addition, 2.1 cm hyperintense focus is noted in the left ischium.
Not sure if Casodex, even though just 50mg per day, has shrank cancer in nodes and bed so MRI didn't detect?
Found my voiding issue = bladder outlet obstruction - may get worse with radiation?
VS 68 Ga PSMA PET/CT 7/25/16
Head and neck - No foci of receptor positive metastatic disease.
Chest - No foci of receptor positive metastatic disease.
Abdomen/pelvis - Postsurgical changes of prostatectomy, with faint uptake in the region of the prostate bed.
A small lymph node along the left pelvic sidewall 8 x 7 mm with mild uptake with a maximum uptake of 5.2. Also, foci of PSMA uptake in the region of the bilateral distal ureters with small external iliac nodes. Activity cannot be differentiated from the ureters and nodes, and these could represent metastatic disease.
Musculoskeletal - No foci of receptor positive metastatic disease.
Age: 69, 69 at PC dx, PSA 6.7 Biopsy: 2/16 13 of 14 Positive, 2-99%, GL 7 (4+3) - RALP 4/20/16 Pathology:Non-Focal EPE, 2 positive margins, Gleason 4+3=7, involving 50% of gland, prostate weight 31.5 g, Stage pT3a N1 Lymph node involvement: 2/10, right side positive, Diameter of largest N Metastisis 2 mm uPSA 6/1/16, 2.41, PSA 6/16/2016, 2.6, 7/12/16, 2.2, 8/11/16 .6
Post Edited (Bobby Mac) : 8/16/2016 5:45:12 AM (GMT-6)