73-year-old male presented with chronic backache radiating to the left lower limb. MRI spine done elsewhere revealed benign L3 vertebral collapse and left hydroureteronephrosis. Further investigations revealed a hard prostate on DRE. TRUS biopsy was adenocarcinoma prostate. Referred for staging workup with G-68 PSMA PET /MR.
T2 W axial (A) coronal(B) sagittal(C) DWI(D) ADC(E) PET MR fused (F) images reveal a T2 hypointense lesion with restricted diffusion, increased capillary permeability with increased PSMA uptake in the left peripheral gland central gland and the adjoining right peripheral gland (arrows)
There is evidence of extraprostatic extension along the left seminal vesicle with stranding seen to extend posterolaterally to lie on the left piriformis muscle in relation to the left sacral plexus nerve roots and enhancing and avid thickening extending intrathecally along the left S1, 2 and 3 exiting nerve roots ( small arrows in ) and enhancing thickening along the left sciatic nerve (Arrows in G-L): the plausible cause of his left LL root pain.
Case Study Prepared by:
This short PET-MRI Scan case was compiled by Dr. Sangeeta Taneja and Dr. Amarnath Jena (Nuclear Medicine Physician at PET-Suite @ Indraprastha Apollo Hospital, Sarita Vihar).
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