If one decides to use a mpMRI to stage a pt with low-risk prostate cancer, how do you work up a focal lesion suspicious for higher grade GS 7-10 disease?  

Even though modern mpMRI is sensitive (>90%) at detecting occult GS ≥4+3 cancers that are missed by blind systematic TRUS biopsies, it is not 100% specific. Almost all radiologists will occasionally over-call a radiographic abnormality when it is still only GS 6. When decisions to be made from...