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. Author manuscript; available in PMC: 2023 Jan 1.
Published in final edited form as: J Urol. 2021 Aug 26:101097JU0000000000002182. doi: 10.1097/JU.0000000000002182

Figure 1.

Figure 1.

Multiparametric MRI image example of clinically significant cancer that was missed due to MRI-targeted biopsy targeting error. 56-year-old male with a serum PSA of 5.9ng/ml. Axial T2-Weighted (T2W) MRI shows a hypointense lesion in the right mid-peripheral zone (arrow) (A), the lesion shows diffusion restriction on ADC map (B) and b2000 DW MRI (C) and early enhancement on DCE MRI (D) (arrows). Targeted biopsy revealed Gleason 3+4 prostate cancer in this lesion, whereas systematic biopsy yielded Gleason 4+4 prostate adenocarcinoma in the right peripheral zone. (E) Screen captures of the TRUS/MRI fusion guided biopsy procedure (E) demonstrates a registration error between MRI (inked in red) vs. TRUS (inked in dashed yellow), which is likely the reason for the under-sampling of the right mid peripheral zone lesion during TRUS/MRI fusion guided biopsy.