Fig. A  Multiparametric MRI revealed a suspicious apical lesion in a large, 86-cc prostate by T2-weighted imaging.

Fig. B Suspicious lesion is also shown on dynamic contrast-enhanced imaging.

Fig. C   Diffusion-weighted imaging also reveals the suspicious apical lesion.

Fig. D   The patient underwent targeted biopsy using MRI-ultrasound fusion.

Fig. E A reconstructed 3-D view of the prostate shows region of interest and biopsy tracks.

Fig. F  All targeted biopsy cores were positive for cancer, up to Gleason score 4+5=9. (Photos courtesy of Jesse Le, MD)