Less susceptibility artifact from the right hip prosthesis using the same b value. PI-RADS 5 lesion of >15 mm in the left anterior prostate with reduced "smudgy" T2 signal and restricted diffusion on the DWI and ADC. Biopsy was very difficult as transrectal ultrasound could not be used. Using the perineum as the acoustic window, transperineal prostate biopsy confirmed Gleason 3+3 cancer, although MRI suggests a higher Gleason score.