Finding: The right posterior TZ demonstrates a partially encapsulated region of moderately decreased T2 signal with similar texture as regions of BPH elsewhere in the TZ. However, the region demonstrates focal markedly decreased ADC and increased high b-value signal.
T2WI: 2. DWI: 5. PI-RADS: 2.
MRI/TRUS fusion biopsy: Gleason score 3+4 tumor.
Comment: Optimal assessment of TZ remains a challenge. Occasionally, DWI may be useful for raising confidence in a TZ lesion in comparison with use of T2WI alone.