Prostate Cancer DFP Teaching Cases by Theme

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Normal Anatomy and Anatomic Variants

Anterior fibromuscular stroma (Silvia Chang)
Prostate MRI Anatomy (Steven C. Eberhardt and Jason Hamblin)
Suspected peripheral zone lesion (Sadhna Verma)

Pathology of prostate adenocarcinoma

  • a.   Anatomic pathology
    b.   Prostate genetics/expression analysis
    c.   Radiogenomics
    d.   Advanced serum analysis (PHI, 4Kscore, etc)

Prostate MRI technique

Ultrasound including contrast enhanced ultrasound and elastography

PIRADS v2.1!!

PIRADS v2

Benign/Pitfalls
Perceptual pitfall- False negative Prostate MRI, Volume averaging of anterior PZ lesion in the apex (Varaha Sai Tammisetti)
Chronic inflammation and BPH nodule (Aritrick  Chatterjee and Aytekin Oto)
Granulomatous prostatitis (Mukesh Harisinghani)
Fungal Infection of Prostate Mimicking Prostate Cancer (Jinxing Yu)
Midline PZ tumor mimicking Central Zone (Sangeet Ghai)
A ‘False Positive’ PI-RADS 5 (Leonardo K Bittencourt and Rodrigo Pamplona Polizio)
False positive PIRADS 5 lesion (Jelle Barentsz)
Encapsulated Prostate Cancer: A Challenge for Scoring at PI-RADS v2 (Fergus Coakley)
Extruded Transition zone nodule (Sangeet Ghai)
Granulomatous Prostatitis (Prasad R Shankar, Nicole E Curci and Matthew S Davenport)
False Positive PI-RADS 4 (Daniel Margolis)
An Uncommon Mimicker (Leonardo Kayat Bittencourt, Nachiketh Soodana Prakash and Sanoj Punnen)
Bilateral lesions (Sangeet Ghai)
Biopsy Pathology: Concordant or Discordant? (Rajan T. Gupta and Jamie N. Holtz)
BPH in the peripheral zone (Jurgen Futterer)
BPH nodule in the PZ (Chan Kyo Kim)
Central Zone (Silvia Chang)
Granulomatous prostatitis (Chan Kyo Kim)
Granulomatous prostatitis (Hebert Alberto Vargas)\
Incidental bladder lesion (David D. Casalino)
Negative spectroscopic imaging (Daniel J A Margolis)
Patient with BCG therapy (Benjamin Spilseth)
Patient with BPH and Urinary Retention (David D. Casalino and Irene M. Hotalen)
Peripheral zone lesion (Antonio Westphalen)
Post-biopsy hemorrhage (Varaha Sai Tammisetti)
Rapid PSA elevation (Benjamin Spilseth)
Stromal BPH nodule (Andrew Rosenkrantz)
Suspected peripheral zone lesion (Sadhna Verma)

Peripheral Zone Tumors

Perceptual pitfall- False negative Prostate MRI, Volume averaging of anterior PZ lesion in the apex (Varaha Sai Tammisetti)
The Two Sides to Prostate Hemorrhage (Rajan T Gupta and Kurren Mehta)
Midline PZ tumor mimicking Central Zone (Sangeet Ghai)
MRI response assessment after neoadjuvant SBRT (Prasad R. Shankar, Daniel E. Spratt and Matthew S Davenport)
Focal Lesion Central PZ Case (Jurgen Futterer)
Quality Improvement: Is the Biopsy Pathology Reflective of Disease Grade? (Rajan T. Gupta and Sitharthan Sekar)
PIRADS 5 Peripheral Zone high grade tumor (Steven Eberhardt and Rachel Runde)
Anterior horn tumor (Jurgen Futterer)
Bilateral lesions (Sangeet Ghai)
Biopsy Pathology: Concordant or Discordant? (Rajan T. Gupta and Jamie N. Holtz)
BPH in the peripheral zone (Jurgen Futterer)
DCE for PZ lesion (Antonio Westphalen)
Extraprostatic extension (Silvia Chang)
Hemorrhage exclusion sign (Sangeet Ghai)
History: Prior negative biopsies (Varaha Sai Tammisetti)
Incidental Finding (Leonardo Kayat Bittencourt)
Intermediate Grade – Negative DCE (Daniel J A Margolis, MD and Naveen Gumpeni, MD)
Mucinous carcinoma of the prostate (Jurgen Futterer)
Paramedian peripheral zone lesion (Sangeet Ghai)
Peripheral zone lesion (Antonio Westphalen)
Peripheral zone PI-RADS 5 lesion (David D. Casalino)
Prostate cancer in setting of Lynch syndrome (Sadhna Verma)
Prostate Cancer on CT (Sandy Lall)
Prostate lesion on CT (Adam Froemming)
Prostate lesion on CT (Steven C. Eberhardt and Martha Terrazas)
Negative spectroscopic imaging (Daniel J A Margolis)
Seminal vesicle invasion (Andrew Rosenkrantz)
Skull base metastasis (Baris Turkbey)
Small cell prostate carcinoma (Adam Froemming)

Transition Zone Tumors

Transition Zone tumor (Rosaleen Parsons)
Encapsulated Prostate Cancer: A Challenge for Scoring at PI-RADS v2 (Fergus Coakley)
PIRADS 5 lesion on active surveillance (Rosaleen Parsons)
Anterior capsular bulge (Sadhna Verma)
Active Surveillance Candidacy & Upgrading (Rajan T. Gupta and Jamie N. Holtz)
Anterior tumor (Nayana Patel)
New lesion on MRI (Rosaleen B. Parsons)
Patient with BPH and Urinary Retention (David D. Casalino and Irene M. Hotalen)
Prior benign saturation biopsy (Rosaleen B. Parsons)
Well-defined Transition Zone Cancer (Jinxing Yu)

Central Zone tumors

Prostate Cancer Located in the Central Zone (Baris Turkbey)
Central zone tumor (Leonardo Kayat Bittencourt)

AFMS tumors

Tumors in other atypical locations
Peri-urethral Prostate Cancer (Marcin Czarkiecki and Baris Turkbey)

Atypical tumors

Prostate Small Cell Carcinoma (Janesh Lakhoo and Sandeep Arora)
STUMP (Silvia Chang)
Prostate Rhabdomyosarcoma (Donald Y. Kim and David D. Casalino)
A ‘False Positive’ PI-RADS 5 (Leonardo K Bittencourt and Rodrigo Pamplona Polizio)
Periprostatic Mass (H. Alberto Vargas)
Periprostatic Urothelial tumor (Sadhna Verma)
Phyllodes tumor of the prostate (Lori Mankowski Gettle)
Ductal Prostate Cancer (Jinxing Yu)
Pelvic mass (Nayana Patel)
Seminal vesicle lesion (Huan Nguyen and Sandy Lall)
Small cell prostate carcinoma (Adam Froemming)

Primary tumor detection with Novel PET tracers

PSMA PET-MRI (Daniel JA Margolis)

Clinical scenarios

Active surveillance
PIRADS 5 lesion on active surveillance (Rosaleen Parsons)
MRI-guided biopsy in patient with progression during AS (Jurgen Futterer)
Anterior tumor (Nayana Patel)
Active Surveillance Candidacy & Upgrading (Rajan T. Gupta)

Surgical planning
Extraprostatic extension (Silvia Chang)
Anterior capsular bulge (Sadhna Verma MD)

Radiation therapy planning
Complication after hydrogel spacer placement (Amie Leon, D Kanmaniraja and Chandana Lall)
Prostate MRI with hydrogel spacer for IMRT (Nayana Patel)
Radiation therapy planning: Role of MRI and Hydrogel (Adam T Froemming and Brad J Stish)

MRI guided biopsies

In-bore
Role of In-Bore MR-guided prostate biopsy: A Case Example and
Literature Review (Nelly Tan)
MRI-guided biopsy in patient with progression during AS (Jurgen Futterer)

MRI-ultrasound fusion
MRI-TRUS Fusion Guided Prostate Biopsy: Is omitting concurrent TRUS-guided systemic biopsy possible?systemic biopsy possible? (Chan Kyo Kim)
MR-TRUS Fusion Guided Biopsy (Leonardo Kayat Bittencourt)
Seminal Vesicle Invasion-When to Suspect and What to do as a Radiologist? (Baris Turkbey)
New lesion on MRI (Rosaleen B. Parsons)
Peripheral zone PI-RADS 5 lesion (David D. Casalino)
BPH nodule in the PZ (Chan Kyo Kim)

Cognitive
MRI/CT Cognitive Fusion Guided Prostate Biopsy (Andrei S Purysko)
Prostate biopsy in a patient without a rectum: Role of CT-guided transgluteal biopsy (Fergus Coakley)

Focal therapies

Pseudoaneurysm in the ablation zone after focal therapy (Varaha Sai Tammisetti and Steven Canfield)
Recurrent Prostate Cancer treated with Cryoablation (Adam T Froemming and Lance A. Mynderse)
MR Guided Focal Laser Ablation (Aytekin Oto)

Staging

Local staging
Staging: Focus on Neurovascular Bundles (Ben Spilseth and Paari Murugan)
Malakoplakia Mimicking Extraprostatic Extension (Silvia Chang)
Seminal Vesicle Invasion-When to Suspect and What to do as a Radiologist? (Baris Turkbey)
Extraprostatic extension (Silvia Chang)
Anterior capsular bulge (Sadhna Verma MD)

Regional staging
Regional Staging of Prostate Cancer on Pelvic MRI (Juliana B Starcevich and Steven C Eberhardt)
Mesorectal lymph node metastasis in prostate cancer (Tharakeswara Bathala and Brian Chapin)
Retropubic lymph node (Janesh Lakhoo and Sandeep Arora)
Not All Enlarged Nodes Related to Prostate Cancer (Mukesh Harisinghani

Whole body staging

Recurrent prostate cancer

Prostate MRI
Local recurrence in Nonsurgically treated Prostate on Axumin PET and Prostate MRI (Vaz Zavaletta and Lori Mankowski Gettle)
Recurrent Prostate Cancer treated with Cryoablation (Adam T Froemming and Lance A. Mynderse)
PSMA PET and MRI Imaging of Early Biochemical Recurrence (BCR) at Remnant Seminal Vesicles after Prostatectomy (Peter L. Choyke and Baris Turkbey)
Mesorectal lymph node metastasis in prostate cancer (Tharakeswara Bathala and Brian Chapin)
Prostate MRI after Radiation Therapy (Antonio C Westphalen)
PSMA PET and MRI Imaging of Biochemical Recurrence (BCR) after Prostatectomy (Peter L. Choyke and Baris Turkbey)
Local Recurrence or Distant Metastasis (Varaha Sai Tammisetti)
Imaging in biochemical recurrence (Amirkasra Mojtahed and Steven C. Eberhardt)
Local recurrence (Nayana Patel)
Post-radiation recurrence (Andrew Rosenkrantz)
Residual Prostate Cancer after Brachytherapy (Baris Turkbey)
Seminal vesicle remnant (Adam Froemming)

Novel PET tracers and functional imaging
Prostate Small Cell Carcinoma (Janesh Lakhoo and Sandeep Arora)
Recurrent Prostate Cancer on Axumin PET (Nayana Patel) 2/4/2019 Current Name: Prostate Cancer DFP Teaching Case
Local recurrence in Nonsurgically treated Prostate on Axumin PET and Prostate MRI (Vaz Zavaletta and Lori Mankowski Gettle)
PSMA PET and MRI Imaging of Early Biochemical Recurrence (BCR) at Remnant Seminal Vesicles after Prostatectomy (Peter L. Choyke and
Baris Turkbey)
Mesorectal lymph node metastasis in prostate cancer (Tharakeswara Bathala and Brian Chapin)
Pelvic Nodal recurrence on Axumin PET-MRI (Andrew Rosenkrantz)
Local recurrence with 68Ga-PSMA-11 PET (Thomas Hope)
PSMA PET and MRI Imaging of Biochemical Recurrence (BCR) after Prostatectomy (Peter L. Choyke and Baris Turkbey)
F18 Fluciclovine PET in Biochemical Recurrence (Hatice Savas and David Casalino)
Local Recurrence or Distant Metastasis (Varaha Sai Tammisetti)

Whole body conventional (anatomic) imaging
CT Flare Response in Metastatic Prostate Cancer (Chan Kyo Kim)
Imaging in biochemical recurrence (Amirkasra Mojtahed and Steven C. Eberhardt)

Whole body MRI

Advanced or Metastatic Prostate Cancer

Response evaluation criteria: PI-RADS, RECIST, and Prostate Cancer Working Group
MRI response assessment after neoadjuvant SBRT (Prasad R. Shankar, Daniel E. Spratt and Matthew S Davenport)
Response Criteria: Prostate Cancer Working Group 3 (Nelly Tan)

Artificial Intelligence/Machine Learning/Deep Learning

Non-prostate findings
Incidental bladder lesion (David D. Casalino)
Incidental Finding (Leonardo Kayat Bittencourt)
Patient with BCG therapy (Benjamin Spilseth)

Miscellaneous
Pelvic mass (Nayana Patel)
Prostate Cancer on CT (Sandy Lall)
Prostate lesion on CT (Adam Froemming)