Prostate, need to get Biopsy.

47 year old. PSA kept rising, highest 3. MRI (2 lesions), it doing well mentally, planning a transperneal Biopsy: CLINICAL INDICATION: Prostate screen, PSA > 3, post repeat (PSA, DRE, benign workup) Encounter for screening for malignant neoplasm of prostate Z12.5; TECHNIQUE: Using a body phased array coil small field-of-view imaging of the prostate was performed using the following sequences; [axial T1-weighted, axial T2-weighted, sagittal T2-weighted, coronal T2-weighted, diffusion-weighted]. Axial T1-weighted images [with fat suppression] through the prostate were obtained performed with administration intravenous contrast. GADOBENATE DIMEGLUMINE 529 MG/ML IV SOLN 17 mL. Using a large field-of-view, the entire pelvis to the level of the aortic bifurcation was imaged with the following sequences fat suppressed T2-weighted, Axial T1-weighted images ] Postprocessing images with DynaCAD software were obtained and submitted for analysis. COMPARISON: No prior studies available to compare PSA level: None provided. FINDINGS: Prostate Size: 3.1 x 4.0 x 4.6 cm Volume: 30 cc TRANSITION ZONE: T2 images demonstrate heterogeneous multinodular appearance, without evidence of suspicious nodules. PERIPHERAL ZONE : Lesion 1: DW images demonstrate focal markedly hypointense on ADC and hyperintense on DWI <1.5 cm (4). T2 images demonstrate circumscribed homogeneous moderate hypointense focus/ mass <1.5cm (4). The lesion is seen in the right posterolateral peripheral zone at the mid gland measuring 0.8 x 0.8 cm (series 11 image 23 and series 6 image 24). Images post contrast demonstrate Diffuse enhancement no corresponding to focal finding on T2 and/or diffusion images PI-RADS (PERIPHERAL ZONE LESION #1: 4 Lesion 2: DW images demonstrate focal discrete and different from background, hypointensity with focal hyperintensity in high DWI (3) T2 images demonstrate round moderate hypointensity (3). The lesion is seen in the right anterolateral peripheral zone on the left at the mid gland to apex measuring 0.6 x 0.6 cm (series 11 image 24). Images post contrast demonstrate Diffuse enhancement no corresponding to focal finding on T2 and/or diffusion images PI-RADS (PERIPHERAL ZONE LESION #2: 3 Extra prostatic extension No Seminal vesicles: Normal serpiginous appearance without thickening of the walls, abnormal restriction or enhancement Bladder: Partially distended without wall thickening. Lymphadenopathy: No suspicious lymphadenopathy. Bones: No enhancing osseous lesions. Other: No bowel obstruction.