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Fig. 2 | European Radiology Experimental

Fig. 2

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

Fig. 2

Use of PI-RADS version 2 criteria to categorise a transition zone (TZ) finding in a 67-year-old patient with elevated PSA (7.80 ng/mL) and previous negative biopsies. On transverse (arrow in a) and sagittal (arrowhead in b) T2-weighted images, there was an anterior, right-sided TZ focal area with lenticular shape, ill-defined margins, and capsular bulging (< 15 mm in size), close to the anterior fibromuscular stroma. This finding was scored as PI-RADS 4 and confirmed to be a Gleason score 6 (3 + 3) cancer on biopsy and subsequent radical prostatectomy (T2b N0). DWI supported the suspicion of malignancy by showing restricted diffusion as corresponding, focal hyperintensity on b = 2000 s/mm2 image (c) and marked hypointensity on the ADC map (d)

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