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We present a 78-years-old male patient with a normal digital rectal exame, showing progressive PSA elevation (currently 14.2 ng/ml). The patient had previously performed ultrasound guided biopsy (TRUS) with negative results. He was then referred to JCC - Hospital Particular de Viana do Castelo to undergo a prostate MRI scan (3T) and subsequent MRI guided biopsy (in-bore system). On T2 weighted imaging we could depict a nodular hypointense lesion with 10 mm of greater diameter, in the anterior gland, at the apex level (Figure 1). The lesion showed restricted diffusion (b 1600) (Figure 2) and reduced ADC value (Figure 3). It was classified PI-RADS 4 (PI-RADS 2.1).

We present a 78-years-old male patient with a normal digital rectal exame, showing progressive PSA elevation (currently 14.2 ng/ml). The patient had previously performed ultrasound guided biopsy (TRUS) with negative results. He was then referred to JCC - Hospital Particular de Viana do Castelo to undergo a prostate MRI scan (3T) and subsequent MRI guided biopsy (in-bore system).