This case shows an already histologically proven bilateral prostate cancer in a patient, who has been receiving androgen deprivation therapy (ADT).

Histology of the systematic biopsy showed an acinar adenocarcinoma (modified Gleason score 4+3=7a, grade 2) within 12/12 cores and perineural nerve sheath infiltration bilaterally.

MRI was done for radiation therapy planning and staging purposes. 

After androgen deprivation therapy an increase of ADC values in prostate cancer and a signal decrease in ADC and T2w images in normal prostatic tissue have been described ^7-10, therefore T2-weighted and ADC images should be interpreted with caution.

Nevertheless, this bpMRI reflects the biopsy findings and suggests extraprostatic extension and invasion of the inferior portions of the seminal vesicles.

The patient received intensity-modulated radiotherapy.