Fig. 6.

False positive mpMRI phenotypes in TPM-negative men (n = 77; three excluded due to incomplete DICOM data). Prostate outlines, transition zones, and all Likert 3–5 lesions (41 index and 12 additional) were annotated on the Osirix platform (T2W, ADC, and DCE sequences; all axial slices). (A) Lesions in each positive sequence are superimposed on a “mean prostate shape” for the TPM-negative group, as described in the Methods. The produced maps confirm a PZ distribution and dominance of a T2W + DWI–DCE + phenotype. (B) Index lesions could broadly be divided into three morphological categories: focal (n = 34), diffuse homogeneous (n = 4), and diffuse heterogeneous (n = 3). Typical examples of lesions of each category are shown in T2W, ADC, b1400, and DCE sequences (white arrows), along with a diagrammatic representation of the three types. ADC = apparent diffusion coefficient; DCE = dynamic contrast enhanced; DWI = diffusion-weighted imaging; mpMRI = multiparametric magnetic resonance imaging; PZ = peripheral zone; TPM = transperineal mapping biopsy; T2WI = T2-weighted imaging.