Two main tools have been proposed to improve prostate cancer characterization, including prostate biopsy and prostate imaging. As these authors state, standard biopsy does not accurately evaluate tumor laterality. Combined T2W and DW MRI parameters with reproducible values may reestablish an accurate estimation of tumor bilaterality in a number of cases misclassified by standard biopsy. Besides MRI, growing evidence indicates that saturation biopsy with strict template guidance also offer promise for cancer staging.1 However, before developing staging strategies that combine saturation biopsy and multiparametric MRI, several challenges must be ruled out. Should MRI be done before biopsy to decrease the risk of artifact? If so, how should patients be selected before biopsy? Also, if data provided by each MRI parameter are discordant, which results should be given more credit? These issues must be addressed further to establish useful clinical recommendations.
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