FOCAL THERAPY OF PROSTATE AND KIDNEY CANCER: Edited by Jean de la Rosette and Thomas J. PolascikMRI to guide biopsies or avoid biopsies?Winoker, Jared S.a; Pinto, Peter A.b; Rastinehad, Ardeshir R.cAuthor Information aDepartment of Urology, Icahn School of Medicine at Mount Sinai, New York, New York bUrologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland cDepartments of Urology and Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA Correspondence to Ardeshir R. Rastinehad, DO, FACOS, Departments of Urology and Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA. Tel: +1 212 241 4812; fax: +1 212 819 7117; e-mail: firstname.lastname@example.org Current Opinion in Urology: November 2018 - Volume 28 - Issue 6 - p 522-528 doi: 10.1097/MOU.0000000000000555 Buy Metrics Abstract Purpose of review To discuss contemporary data on the value of multiparametric MRI (mpMRI) for guiding the decision to biopsy men at risk for prostate cancer, as well as its utility in active surveillance programs. Recent findings Although a systematic 12-core biopsy is the current standard of care for men with increased suspicion for prostate cancer, MRI with or without targeted biopsy has been shown to reliably improve the detection of clinically significant disease following a prior negative biopsy. At the same time, there is a growing body of evidence to support the use of MRI for diagnostic purposes in biopsy-naive patients, as well for enrolling and monitoring men on active surveillance programs. Summary mpMRI is an evolving technology with great promise for altering our approach to prostate cancer diagnosis and surveillance. In conjunction with targeted biopsies, MRI offers greater specificity for the detection of clinically significant cancer and therefore may help to reduce overdetection of indolent disease while minimizing the risks and limitations of systematic biopsies. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.