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| | (A1) T2W imaging for the peripheral zone |
| | (1) Uniform high signal intensity |
| | (2) Linear, wedge-shaped, or geographical areas of lower signal intensity, usually not well demarcated |
| | (3) Intermediate appearances not in categories 1/2 or 4/5 |
| | (4) Discrete, homogeneous low-signal focus/mass confined to the prostate |
| | (5) Discrete, homogeneous low-signal-intensity focus with extracapsular extension/invasive behavior or mass effect on the capsule (bulging) or broad (>1.5 cm) contact with the surface |
| | (A2) T2W imaging for the transition zone |
| | (1) Heterogeneous transition zone adenoma with well-defined margins: “organized chaos” |
| | (2) Areas of more homogeneous low signal intensity, however, well marginated, originating from the transition zone/benign prostatic hyperplasia |
| | (3) Intermediate appearances not in categories 1/2 or 4/5 |
| | (4) Areas of more homogeneous low signal intensity, ill defined: “erased charcoal sign” |
| | (5) Same as 4, but involving the anterior fibromuscular stroma or the anterior horn of the peripheral zone, usually lenticular or water-drop shaped |
| | (B) Diffusion-weighted imaging |
| | (1) No reduction in ADC compared with normal glandular tissue; no increase in signal intensity on any high-b-value image (≥b800) |
| | (2) Diffuse, hyper signal intensity on ≥b800 image with low ADC; no focal features; however, linear, triangular, or geographical features are allowed |
| | (3) Intermediate appearances not in categories 1/2 or 4/5 |
| | (4) Focal area(s) of reduced ADC but isointense signal intensity on high-b-value images (≥b800) |
| | (5) Focal area/mass of hyper signal intensity on the high-b-value images (≥b800) with reduced ADC |
| | (C) Dynamic contrast-enhanced MRI |
| | (1) Type 1 enhancement curve |
| | (2) Type 2 enhancement curve |
| | (3) Type 3 enhancement curve |
| | (+1) For focal enhancing lesion with curve types 2-3 |
| | (+1) For asymmetric lesion or lesion at an unusual place with curve types 2-3 |
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