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Fig. 1 | Insights into Imaging

Fig. 1

From: False positive and false negative diagnoses of prostate cancer at multi-parametric prostate MRI in active surveillance

Fig. 1

A 54-year-old male with low volume Gleason score 3 + 3 = 6 PCa at TRUS-guided biopsy in the right middle peripheral zone (PZ). MP-MRI was performed because of rising PSA to exclude clinically significant (CS) tumour. Axial (a) and coronal (b) T2-weighted (T2W) turbo spin echo (TSE) images demonstrate bilateral foci of low T2 signal intensity (SI) at the prostate base (dotted arrows) adjacent to the insertion of the vas deferens (not shown). Axial apparent diffusion coefficient (ADC) map (c) at the same level demonstrates corresponding low SI (white arrows). These areas were described as suspicious and repeat targeted TRUS-guided biopsy was suggested. A repeat biopsy with multiple cores through both areas yielded only normal prostatic tissue. A repeat MRI performed 2 years later demonstrates similar findings on the T2W (d) and ADC map (e), which represent the normal central zone. Corresponding b1000 mm²/s trace echo-planar image (EPI) does not show concordant areas of increased SI (white arrows in f) and there is benign progressive enhancement on dynamic contrast-enhanced (DCE) imaging (g)

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