Fig. 2

A 66-year-old man presented with a persistently elevated prostate-specific antigen (PSA) range of 7.08–8.58 ng/ml over a period of six months. T2-weighted imaging (A) revealed a hypointense lesion in the right periphery of the prostate (arrow) showing hyperintense on the diffusion weighted imaging (DWI) (B, arrow), and hypointense on the apparent diffusion coefficient (ADC) maps (C, arrow) resulting in a Prostate Imaging-Reporting and Data System (PI-RADS) score of 4. However, positron emission tomography/computed tomography (PET/CT) images (D, CT; E, PET; F, fusion) showed no prostate-specific membrane antigen (PSMA) uptake in the involved region. According to the predictive model, the probability of clinically significant prostate cancer for this lesion is 0.10 (< 0.35). Subsequent prostate biopsy result in benign prostatic hyperplasia accompanied by prostatitis. Following 1-year of symptomatic treatment, the patient’s PSA returned to normal