Prostate Cancer
Axial T2 sequence shows the darker lesion in the left peripheral zone (red arrow) compared to the normal increased T2 signal in the contralateral peripheral zone.
Case overview
This case illustrates the pivotal role of whole body MRI (WB-MRI) in identifying early disease processes, guiding personalized care, and improving long-term health outcomes in asymptomatic patients.
Patient History
- 70-year-old asymptomatic male underwent a WB-MRI to proactively monitor his health
- Prostate-specific antigen (PSA) was 3.6ng/mL, which is within a normal range for a patient of his age
Findings
- A 2.2cm lesion was detected in the left side of the prostate gland (Figure 1, Figure 2, & Figure 3)
- An advanced MRI technique was used to identify restricted diffusion, increasing specificity suggestive of cancer, in addition to the hypo-intensity of the lesion
Axial diffusion-weighted image shows increased signal intensity (red arrow), which may represent edema (T2 shine-through) or restricted diffusion.
Axial ADC image confirms restricted diffusion in this PIRADS-5 lesion (red arrow), highly suggestive of prostate cancer.
Follow-up care
- Screening WB-MRI clearly identified this PIRADS-5 lesion, which was promptly confirmed from image-guided targeted biopsy and then treated with prostatectomy surgery.
How the Prenuvo scan impacted patient care:
- Despite having undergone standard prostate cancer screening with a PSA blood test, which was within normal limits for his age, traditional healthcare would likely not have detected this silent cancer without the presence of symptoms. This could have led to disease progression, a worsened prognosis, and the need for more aggressive treatment once it was finally identified.
Prostate Cancer & PSA Testing
Prostate cancer is one of the most common cancers in men and often progresses without noticeable symptoms. Recent advances, such as WB-MRI, provide a safeguard against many conditions that might otherwise go undetected.
PSA screening involves a blood test to measure the level of a protein produced by the prostate gland. Elevated PSA levels can indicate prostate cancer but may also result from non-cancerous conditions like an enlarged prostate, recent exercise, invasive medical procedures, or infections. Therefore, screening solely through PSA has its limitations. For example, false positives can lead to unnecessary anxiety and invasive follow-up procedures, such as biopsies. While PSA testing is quick, inexpensive, and widely accessible, it can lack specificity and sometimes result in overdiagnosis or overtreatment (American Cancer Society, 2023).
References
American Cancer Society. (2023). Prostate Cancer Early Detection. Retrieved from American Cancer Society Website
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