Multiparametric MRI of the prostate demonstrates an anterior tumour involving the transition zone (TZ) and anterior fibromuscular stroma (AFS): PI-RADS 5.
There is a large smooth homogeneous anterior region of interest in the TZ/AFS. This demonstrates the so called 'smudged or erased charcoal sign'. There is high signal on b1400 DWI and a decrease in ADC to around 700. The lesion enhances early.