Fig. 3

A 54-year-old patient with elevated and rising PSA. Axial T2W TSE (a) demonstrates a low SI focus in the anterior midline (dotted arrow) with corresponding low SI (white arrow) on the axial ADC map (b). This area was reported as suspicious for tumour. Repeat non-targeted biopsies of the PZ revealed Gleason score 3 + 4 = 7 tumour in the right PZ (not shown) and the patient underwent radical prostatectomy (RP). The structure highlighted on MRI is the normal anterior fibromuscular stroma (AFMS); note: characteristic midline anterior location on axial T2 (a) and benign progressive enhancement on DCE (c). Also note that low SI on the ADC (b) map is due to inherently low T2 SI rather than restricted diffusion; there is a lack of increased SI on trace b1000 mm²/s EPI (d). Whole-mount histopathology image of the RP specimen (e) demonstrates the AFMS (black arrow), which is predominantly composed of smooth muscle that blends with the overlying prostate stroma