Fig. 3
From: In prostatic transition zone lesions (PI-RADS v2.1): which subgroup should be biopsied?
Multiparametric magnetic resonance image of a 60-year-old patient who underwent radical prostatectomy (serum prostate-specific antigen 4.1 ng/ml, apparent diffusion coefficient [ADC] 0.887). An axial T2-weighted image (T2WI) (a) and dynamic contrast-enhanced image (b) indicate an approximately 1 cm, heterogeneous, obscured, marginated nodule with minimal enhancement in the left transition zone (arrows), resulting in a T2WI score of 3. Diffusion-weighted imaging (DWI) (b = 1000) (c) demonstrated high signal intensity at the corresponding nodule with low signal intensity on an ADC map (d), resulting in a DWI score of 4. This lesion was categorized as 3 according to PI-RADS v2.1 but as 3B according to PI-RADS v2.1-B. The patient underwent radical prostatectomy, which confirmed transition-zone cancer with a Gleason score of 7 (4 + 3). The procedure revealed multiple poorly formed glands with peripherally arranged nuclei and a macronucleolus (e)