Training Collections
Library Memberships
Black Friday Save 30%On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Black Friday Save 30%Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Black Friday Save 40%Unlock access to our full Course Library and all self-paced Fellowships.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Dr. Resnick's MSK Conference
BLACK FRIDAY SAVE 30%Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
Training Collections
Library Memberships
Black Friday Save 30%On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Black Friday Save 30%Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Black Friday Save 40%Unlock access to our full Course Library and all self-paced Fellowships.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Dr. Resnick's MSK Conference
BLACK FRIDAY SAVE 30%Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
2 topics, 9 min.
11 topics, 1 hr. 2 min.
Zonal Anatomy
5 m.Subdividing the Prostate Zones in the Axial Plane
4 m.Coronal Anatomy
5 m.Proximal to Distal Anatomy
6 m.Sagittal Anatomy
6 m.Prostate Anatomy on MRI in the Axial Projection
12 m.Prostate Anatomy on MRI in the Sagittal Projection
9 m.Utilizing the Axial Sequence
5 m.Identifying Prostate Zones on MRI
9 m.Prostatic Urethra
4 m.Membranous Urethra
3 m.8 topics, 20 min.
29 topics, 1 hr. 24 min.
Introduction to PI-RADS 2.1
5 m.PI-RADS assessment - Peripheral Zone
2 m.PI-RADS assessment - DWI
3 m.PI-RADS assessment - Transition Zone
2 m.Transition Zone T2 Scoring
3 m.Peripheral Zone DWI Scoring
3 m.PI‐RADS Assessment for DCE
4 m.Prostate Anatomy - Sector Map
4 m.Prostate Anatomy - Cross Sectional Review
5 m.Ellipsoid Volume
5 m.Image Acquisition T2WI
3 m.Image Acquisition DWI
3 m.Image Acquisition: DCE
3 m.Image Interpretation: DWI
4 m.Image Interpretation: DWI Score 2 vs. 3
5 m.Assessment of T2W in the Transitional Zone: Score 1
4 m.Assessment of T2W in the Transitional Zone: Score 2
4 m.T2W Score 2 - Summary
3 m.TZ Nodules and Corresponding Scores
3 m.PI-RADS 2 vs. PI-RADS 3
2 m.Diagrammatic TZ Assessment
7 m.Image Interpretation DCE: Modified Criteria
3 m.Biparametric MRI
4 m.Philosophical Approach to Central Zone Malignancy (1)
3 m.Philosophical Approach to Central Zone Malignancy (2)
3 m.Central Zone Pitfalls
3 m.Normal Anterior Fibromuscular Stroma
2 m.Anterior Fibromuscular Stroma - Malignancy Criteria
2 m.Anterior Fibromuscular Stroma - Advanced Problem Solving
4 m.3 topics, 6 min.
12 topics, 1 hr. 18 min.
Case Review: PI-RADS 4, Stage IIB
4 m.Case Review: PI-RADS 4
5 m.Case Review: Staging a PI-RADS 5 Lesion
11 m.PI-RADS 4/5
9 m.Case Review: PI-RADS 4/5 - Compare With Prior 3T
12 m.Case Review: PI-RADS 5 & 3
11 m.Case Review: PI-RADS 4 – Making Use of the ADC Map
5 m.Case Review: Charcoal Sign in the Transition Zone
5 m.Case Review: Pitfall – T2 Blackout Sign
6 m.Case Review: When the Diffusion Imaging Fails
4 m.Case Review: When not to use the Leikert Grading System
6 m.Case Review: Interesting PI-RADS 4 Case
7 m.4 topics, 18 min.
3 topics, 11 min.
0:00
Let's look at a classification system for
0:04
benign prostatic hypertrophy on MR imaging.
0:08
We've got three two-dimensional fast
0:11
spin echo images of the prostate,
0:14
axial, sagittal, and coronal.
0:17
So let's begin with the low bar
0:20
classification system for BPH.
0:23
Type 1.
0:26
The enlargement is predominantly anterior
0:29
and pushes the urethra towards the back.
0:32
There is some anterior hypertrophy in this case.
0:37
Type 2.
0:39
There'd be a solitary area of retrourethral,
0:43
there's the urethra, retrourethral
0:45
enlargement, but above the verumontanum.
0:48
And we do have that.
0:51
If we had that and it was
0:52
isolated, it would be a type 2.
0:55
What's a type 3?
0:57
Type 3 is when you have both and they're balanced.
0:59
This one is a type 3.
1:01
It's balanced.
1:02
Both the anterior gland, maybe a little
1:05
imbalanced, and the posterosuperior gland
1:08
are enlarged above the verumontanum.
1:10
So I would say this one's a little
1:12
bigger, it's slightly imbalanced
1:14
towards the back than the front.
1:17
What's it type for?
1:19
Prominence of the median lobe, the periurethral
1:21
tissues, which may push the central zone up,
1:26
but also invaginate and encroach on the urethra.
1:30
As a pedunculated mass.
1:32
This one is actually the least common
1:34
and hardest to see because everything
1:37
gets crowded around the urethra.
1:39
And it's hard to know whether you're
1:40
seeing an intramural lesion that's
1:43
pushing in or a pedunculated lesion
1:46
with a stalk that's pushing in.
1:48
So that one to designate in an isolated
1:50
fashion as a type 4 requires very high
1:53
resolution one-millimeter or thinner MRI.
1:57
So those are the four low bar classifications.
2:01
Which you can use and
2:02
extrapolate onto the MR image.
2:04
This, an example of a pretty balanced hypertrophy.
2:07
A little more in the back than the front.
2:11
A type 3 pattern of lobar BPH.
Interactive Transcript
0:00
Let's look at a classification system for
0:04
benign prostatic hypertrophy on MR imaging.
0:08
We've got three two-dimensional fast
0:11
spin echo images of the prostate,
0:14
axial, sagittal, and coronal.
0:17
So let's begin with the low bar
0:20
classification system for BPH.
0:23
Type 1.
0:26
The enlargement is predominantly anterior
0:29
and pushes the urethra towards the back.
0:32
There is some anterior hypertrophy in this case.
0:37
Type 2.
0:39
There'd be a solitary area of retrourethral,
0:43
there's the urethra, retrourethral
0:45
enlargement, but above the verumontanum.
0:48
And we do have that.
0:51
If we had that and it was
0:52
isolated, it would be a type 2.
0:55
What's a type 3?
0:57
Type 3 is when you have both and they're balanced.
0:59
This one is a type 3.
1:01
It's balanced.
1:02
Both the anterior gland, maybe a little
1:05
imbalanced, and the posterosuperior gland
1:08
are enlarged above the verumontanum.
1:10
So I would say this one's a little
1:12
bigger, it's slightly imbalanced
1:14
towards the back than the front.
1:17
What's it type for?
1:19
Prominence of the median lobe, the periurethral
1:21
tissues, which may push the central zone up,
1:26
but also invaginate and encroach on the urethra.
1:30
As a pedunculated mass.
1:32
This one is actually the least common
1:34
and hardest to see because everything
1:37
gets crowded around the urethra.
1:39
And it's hard to know whether you're
1:40
seeing an intramural lesion that's
1:43
pushing in or a pedunculated lesion
1:46
with a stalk that's pushing in.
1:48
So that one to designate in an isolated
1:50
fashion as a type 4 requires very high
1:53
resolution one-millimeter or thinner MRI.
1:57
So those are the four low bar classifications.
2:01
Which you can use and
2:02
extrapolate onto the MR image.
2:04
This, an example of a pretty balanced hypertrophy.
2:07
A little more in the back than the front.
2:11
A type 3 pattern of lobar BPH.
Report
Editorial Note
Faculty
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
ProScan Imaging
John F. Feller, MD
Chief Medical Officer, HALO Diagnostics. Medical Director & Founder, Desert Medical Imaging. Chief of Radiology, American Medical Center, Shanghai, China.
HALO Diagnostics
Tags
Prostate/seminal vesicles
MRI
Genitourinary (GU)
Body
Acquired/Developmental
© 2024 Medality. All Rights Reserved.