PI-RADS (Prostate Imaging Reporting and Data System) determination is dependent on whether the lesion is in the peripheral zone (PZ) or transition zone (TZ).  

For PZ the primary determining sequence is DWI. That is, the PI-RADS score is determined by DWI appearance, with the exception of PI-RADS 3 lesions, at which further reference is made to the presence or absence of dynamic contrast enhancement (DCE) in an attempt to minimize "indeterminate" lesions.

In this case, regarding the imaging findings and the PI-RADS (Prostate Imaging Reporting and Data System), prostate adenocarcinoma is suggested with the overall grading of PI-RADS 4.