Figure 7a. Biopsy-proved Gleason grade 8 adenocarcinoma in a 58-year-old man with a PSA level of 50.0 ng/mL. T2-weighted axial (a) and sagittal (b) MR images reveal a large tumor (T) that invades the entire prostate gland and demonstrate gross extracapsular extension and direct invasion of the urinary bladder (arrow in a) and seminal vesicles (arrow in b).