Fig. 2

Example of the method used for lesion localization. A Readout of PSMA PET/MRI by one of the readers with the prostate gland divided in 4 quadrants (Q1: anterior right; Q2: anterior left; Q3: posterior left and Q4: posterior right). The reader delineated three areas of ⁶⁸Ga-PSMA-11 uptake and labeled area 1 as suspicious for malignancy and areas 2 and 3 as benign/physiological. B ⁶⁸Ga-PSMA-11 PET/MRI images of this patient show physiological bilateral uptake in the central zone (arrows) and a suspicious area with intense uptake in the posterior peripheral zone on the left (D). C histopathological map automatically generated by the biopsy fusion software with numbered biopsy cores, red spots represent the localization of needles with Gleason score ≥ 3 + 4, confirming the suspicious lesion on Q3 and showing another lesion on Q1 not depicted on PSMA PET/MRI. For the analysis , Q1 was considered false-negative, Q2 true-negative, Q3 true-positive and Q4 false-negative (lesion crossing the midline not depicted by imaging)