This study investigated the multi-parametric MRI features and pathologic outcome of wedge shaped lesions on T2-weighted images in 76 patients. A greater percentage of wedge shaped features were found to be malignant than shown previously. Malignant wedge shaped regions were primarily highly hypointense on ADC maps and showed early enhancement on DCE-MRI. Benign wedge shaped lesions were predominantly mildly hypointense on ADC maps and showed no early enhancement and pathologically outcome showed prostatitis, hemosiderin-laden macrophages, prominent blood vessels, intraluminal blood and atrophy. Malignant wedge shaped lesions were found to have significantly lower ADC compared to benign wedge shaped regions.