Fig. 6
From: In prostatic transition zone lesions (PI-RADS v2.1): which subgroup should be biopsied?
Multiparametric magnetic resonance image of a 81-year-old patient with serum PSA 15.9 ng/ml. An axial T2-weighted image (T2WI) and dynamic contrast-enhanced image (a, b) indicate an approximately 1.3 cm, obscured marginated, heterogeneous nodule with minimal enhancement in the right transition zone (arrows), resulting in a T2WI score of 3. The other 9-mm-sized encapsulated, homogeneous nodule was detected in the left transition zone (opened arrows), revealing T2WI score of 2. Diffusion-weighted imaging (DWI) (b = 1000) and ADC map (c, d) demonstrated focal marked diffusion restriction at the corresponding right transition zone nodule (arrows) with low signal intensity on an ADC map (DWI score 4, with ADC value of 0.620), and left transition zone nodule revealed no diffusion restriction (DWI score 1, with ADC value of 1.040). These lesions were each categorized as category 3B (right transition zone) and 2 (left transition zone), according to PI-RADS v2.1-B, and we recommended biopsy for right transition zone nodule. These lesions were confirmed right transition-zone cancer with a Gleason score of 7 (3 + 4), and benign hyperplastic nodule in left transition zone, each