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Fig. 1 | European Radiology Experimental

Fig. 1

From: Evolution of prostate MRI: from multiparametric standard to less-is-better and different-is better strategies

Fig. 1

Application of the Prostate Imaging Reporting and Data System (PI-RADS) version 2 in interpreting a finding in the peripheral zone (PZ) of a biopsy-naïve 62-year-old man undergoing prostate multiparametric magnetic resonance imaging (mpMRI) for elevated prostate specific antigen (PSA) level. The dominant sequence, i.e., a transverse diffusion-weighted imaging (DWI) sequence, showed an area (< 15 mm in size) of restricted water diffusion in the left midgland PZ, as testified by high signal intensity on the b = 2000 s/mm2 image (arrow in a) and corresponding marked hypointensity on the apparent diffusion coefficient (ADC) map (b). This finding was classified as PI-RADS 4 accordingly, with additional ancillary suspicious features such as hypointensity on transverse T2-weighted imaging (c) and focal early contrast enhancement on subtracted T1-weighted imaging (d). Pathology after radical prostatectomy found a Gleason score 7 (3 + 4) T3a N0 cancer

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