This highlights the difficulty in interrogating the transition zone of the prostate. This nodule was biopsied and proved benign under MRI guidance and was also not avid at PSMA PET.

The well-defined appearance (in all three planes on T2W) is the key to defining this as a stromal nodule on T2W. If it enhances or restricts, it does not change this. If you feel it is ill-defined then a T2W grading of 3 or maybe 4 can be used. If a T2W grading of 3 then a DWI grading of 5 will upgrade the overall grading to 4.