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Prostate MR: pitfalls and benign lesions


Multiparametric MRI (mpMRI) of the prostate has evolved to be an integral component for the diagnosis, risk stratification, staging, and targeting of prostate cancer. However, anatomic and histologic mimics of prostate cancer on mpMRI exist. Anatomic feature that mimic prostate cancer on mpMRI include anterior fibromuscular stroma, normal central zone, periprostatic venous plexus, and thickened surgical capsule (transition zone pseudocapsule). Benign conditions such as post-biopsy hemorrhage, prostatitis or inflammation, focal prostate atrophy, benign prostatic hyperplasia nodules, and prostatic calcifications can also mimic prostate cancer on mpMRI. Technical challenges and other pitfalls such as image distortion, motion artifacts, and endorectal coil placements can also limit the efficacy of mpMRI. Knowledge of prostate anatomy, location of the lesion and its imaging features on different sequences, and being familiar with the common pitfalls are critical for the radiologists who interpret mpMRI. Therefore, this article reviews the pitfalls (anatomic structures and technical challenges) and benign lesions or abnormalities that may mimic prostate cancer on mpMRI and how to interpret them.

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Corresponding author

Correspondence to Aytekin Oto.

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Conflict of interest

Dr. Aritrick Chatterjee and Dr. Stephen Thomas have no disclosures. Dr. Aytekin Oto has the following disclosures. Research Grant, Koninklijke Philips NV Research Grant, Guerbet SA Research Grant, Profound Medical Inc. Medical Advisory Board, Profound Medical Inc Speaker, Bracco Group.

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Chatterjee, A., Thomas, S. & Oto, A. Prostate MR: pitfalls and benign lesions. Abdom Radiol 45, 2154–2164 (2020).

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  • mpMRI
  • Prostate cancer
  • DWI
  • Pitfalls
  • Benign lesions