Fig. 2

The patient is 78 years old, with TPSA: 62.43 ng/mL. MpMRI showing suspicious signals in the 6–8 O'clock direction of the right peripheral zone (blue arrow), mpMRI ( +). MpMRI showing a nodule in the 5 O'clock direction of the left peripheral zone (white arrow), mpMRI (-). Pathological results implying that the lesions in the right and left peripheral zones are carcinomas, with a Gleason score of 3 + 4 = 7 and 4 + 3 = 7, respectively. (A) MpMRI-TRUS fusion showing the bilateral peripheral gland hypoechoic area, with the sign of capsule bulge in the left peripheral zone. (B) CEUS in the targeted area showing fast-forward and backward enhancements (13 s) as well as hyperperfusion in the right peripheral zone. CEUS in the targeted area showing nonperfusion in the left peripheral zone. (C) TRES of the targeted area showing asymmetric, focal non-strain (the area in the middle of the lesion is blue and the surrounding tissue is green). (D, E) Punctures of the targeted area