How do you deal with a discordant MRI prostate after a systematic biopsy?

This is a good question and something that we are coming across more often.

A few assumptions that I am making with reference to your question: When you state “discordant” MRI prostate after biopsy, I am assuming that you mean that the biopsy demonstrated something like Gleason 3+3 or maybe nothing at all (perhaps PIN), and the MRI demonstrated a large lesion that was graded as PI-RADS 4 or 5.

So if this happens, first I look at where the lesion is located on the MRI. If the lesion if very anterio...