Prostate cancer in a 73-year-old man with a PSA level of 12.3 ng/mL and a history of a negative biopsy findings.

A. Axial T2-weighted image in a 71-year-old man with prostate cancer in the left TZ shows homogeneous low signal intensity, ill-defined margins, and lack of a hypointense capsule (arrow). B. Corresponding ADC map shows restricted diffusion as area of low signal intensity (arrow). C. Axial perfusion map shows focal enhancement in left TZ (arrow). D. Time intensity curve shows red, type 3 enhancement curve (red circle: cancer focus). Green curve is type 1 enhancement pattern (green circle: normal tissue). E. Axial transrectal US image acquired after contrast material injection shows the corresponding an asymmetric early wash-in area on contrast pulse sequence–mode images (outlined by asterisks). Biopsy was performed targeting this area, and we were able to confirm the presence of cancer. Histopathologic examination indicated a prostate carcinoma with a Gleason score of 6 (3+3) at targeted biopsy (TB) only.