These are images from the study of a 64-year-old man with conventional PI-RADSv2.1 category 3 nodule. A) axial and B) coronal T2w MR image shows a heterogeneous nodule with obscured margins measuring 14 mm (arrow) in the left base posterior transition zone (T2 score 3). C) ADC map shows focal decreased signal intensity (arrow) without corresponding high signal intensity on D) echo-planar DWI (b=1500 mm2/s) sequences (arrow). This lesion was categorized as a conventional PIRADS v2.1 category 3 by all readers. Ultrasound targeted biopsy demonstrated no evidence of malignancy.
Title - Prevalence of prostate cancer in PI-RADS version 2.1 transition zone ‘atypical nodules’ upgraded by abnormal diffusion weighted imaging: correlation with MRI-directed TRUS-guided targeted biopsy.