81 Year Old male - Prostate Gleason 4+5 with T3b

More info - I had the MRI, then a biopsy, and then a PET scan. Here are results of the PET.
PROCEDURE:
The patient was evaluated with a dedicated PET/CT scanner. 5.0 mCi of
Ga68 PSMA ILLUCCIX was injected IV at 1105 hours. 63 minutes
post-injection, CT attenuation-correction images and subsequent PET
images (attenuation-corrected and emission-only images) were obtained
from skull base to mid thigh. PET, noncontrast-attenuation CT, and
fused PET/CT images were then reformatted and reviewed in the axial,
sagittal, coronal and 3-D maximum intensity projection planes.

FINDINGS:
HEAD AND NECK:
Physiologic radiotracer distribution.

CHEST:
Lungs, Pleura and Airways: No avid pulmonary nodules. Trace bilateral
pleural effusions. Mild bibasilar atelectasis. No airway narrowing or
obstruction. No pneumothorax.
Mediastinum: Ectatic ascending aorta. Coronary artery calcifications.
Trace pericardial effusion.
Lymph Nodes: No pathologically enlarged lymph nodes or lymph nodes with
abnormal activity.

ABDOMEN:
Liver and Biliary: No biliary abnormality. No abnormal activity in the
liver.
Pancreas, Spleen and Adrenals: No abnormal activity in the pancreas,
spleen, or adrenal glands.
Kidneys: No hydronephrosis or calculus.

ABDOMEN AND PELVIS:
Bowel: No small bowel or colonic dilatation. Scattered colonic
diverticulosis without evidence of acute diverticulitis. Physiologic
activity present in bowel loops.
Vessels: No aneurysm. Moderate-severe calcific atherosclerosis.
Lymph Nodes: No pathologically enlarged lymph n1odes or lymph nodes
with abnormal activity.
Peritoneum and Retroperitoneum: No intraperitoneal free air, ascites or
peritoneal mass. No significant retroperitoneal abnormality.

PELVIS:
Genitourinary: Focal uptake in the left hemiprostate, SUV max 9.3
(fused axial image 154), with suspected invasion of the inferior aspect
of the left seminal vesicle (fused axial image 150). No hydroureter.
Radiotracer activity along the bilateral ureters, compatible with
physiologic urinary activity.

Body Wall: Right inguinal hernia containing a short segment of small
bowel, without bowel obstruction. No masses or hemorrhage.
Bones: No acute fracture or vertebral end plate destruction. No
PSMA-avid lytic or blastic lesion. Scattered multilevel degenerative
changes in the spine. Right shoulder arthroplasty with associated beam
hardening artifact.

Impression
Summary of Target Lesions:
-Focal uptake in the left hemiprostate, SUV max 9.3 (fused axial image
154), with suspected invasion of the inferior aspect of the left
seminal vesicle (fused axial image 150).

Comments:
1. PSMA uptake in the prostate consistent with known malignancy, with
suspected left seminal vesicle invasion.
2. No evidence of avid metastatic disease.
3. Trace bilateral pleural effusions. Trace pericardial effusion.
4. Right inguinal hernia containing a short segment of small bowel,
without bowel obstruction.