Figure 6.

Example of direct MRI-guided biopsy in a biopsy naïve 65-year-old patient with a screening PSA of 6 ng/m. (A) Axial T2-weighted MR image shows a concerning ellipsoid focus (arrow) of reduced T2 signal in the left peripheral zone; (B) axial apparent diffusion coefficient map shows a marked corresponding reduction in diffusion (arrow), also concerning for tumor; (C) axial oblique T2-weighted MR image obtained in the plane of the needle sleeve after needle deployment during direct MRI-guided biopsy shows the needle (open arrows) traversing the medial aspect of the target (white arrow). A second core was taken slightly more laterally (not shown). Pathology showed Gleason 5+4 cancer in both cores, and also in a subsequent radical prostatectomy specimen.