Figure 8a. Biopsy-proved Gleason grade 7 adenocarcinoma in a 62-year-old man with a PSA level of 15.1 ng/mL. T2-weighted axial (a) and sagittal (b) MR images demonstrate diffuse tumor invasion of the prostate gland with direct tumor (T) extension to the wall of the urinary bladder and the anterior rectal wall (white arrow). The multiple low-signal-intensity lesions (black arrows in a) in the pubic bones are consistent with bone metastases.