Table 1 Description of MRI criteria suggestive for malignancy or DIPL according to different MRI sequences

T2w

Peripheral zone: inhomogeneous, irregular, low-signal intensity lesion with unclear margins or diffuse extension and mass effect.

Central gland (transition zone), [23] homogeneous low-signal intensity region with:

• Poorly defined or spiculated lesion margins

• Lack of a low-signal-intensity rim (seen commonly in association with benign adenomatous nodules),

• Interruption of the surgical pseudocapsule (transition zone–to–peripheral zone boundary of low signal intensity),

• Urethral or anterior fibromuscular stromal invasion, and

• Lenticular shape

Diffusion weighed (DWI, using ADC-maps)

Round-ellipsoid low intensity regions are suggestive of prostate cancer lesions [21, 22].

Potential limitation: the high prevalence of benign prostate hyperplasia (BPH) may lead to low intensity nodules like cancerous tissue.

Dynamic contrast enhanced (DCE)

Focus of asymmetric, early and intense enhancement with rapid washout compared to the background.

Potential limitation: enhancing prostatitis in the peripheral zone and enhancing BPH in the transition zone [32].