Fig. 11

A 59-year-old patient with Gleason 3 + 4 = 7 cancer in the left middle PZ on TRUS biopsy underwent MP-MRI for staging. Axial T2W TSE image shows a subtle lesion in the left middle PZ (white arrow in b) with type III kinetics on DCE (b) and profound restricted diffusion on ADC map (white arrow in c). Typically with conventional acinar adenocarcinoma T2W signal intensity mirrors findings on ADC map, the discordant findings with only minimally decreased T2W signal and profound restricted diffusion can be seen in ductal variant adenocarcinoma. Final histopathology after RP was Gleason score 4 + 4 = 8 tumour with dominant ductal component