To evaluate the hypoechoic peripheral zone lesions detected at trans-rectal ultrasound (TRUS) in patients with normal PSA, we carried out a retrospective study on 12 men who underwent transrectal ultrasound-guided biopsy. None of them showed prostatic cancer at first mapping. We therefore did a follow-up with TRUS, PSA and digital rectal exploration (DRE). 9 patients underwent mapping again. The only patient who was positive for prostatic cancer had PSA > 4 ng/ml, negative TRUS and DRE. Our results confirmed the low predictive value of hypoechoic peripheral zone lesions and the change in TRUS Patterns. We therefore consider that patients with just a TRUS suspicion which is negative at first mapping, can be monitorized with PSA while TRUS should only be used for biopsy.