This study investigates why some prostate cancers are not identified on mpMRI using ground truth reference from whole mount prostatectomy specimens. Unidentified cancers tend to exhibit lower Gleason grade and pathologic stage, smaller size, lower density of glands compared to surrounding tissue (sparse cancer lesions) and have different tissue composition, specifically higher lumen (associated with high ADC and T2) and lower epithelium (associated with low ADC and T2) compared to cancer lesions identified on MRI.
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