Prostate cancer (PCa) clinic is challenged by heterogeneously distributed and clinical insignificant diseases. Multiparametric (mp)-MRI, with a PI-RADS score, correlated to clinically significant cancer and its morphological variations to establish a biopsy Target, and ultrasound fusion-guided biopsy guided to the targeted area has increased detection of clinically significant cancer. We studied PI-RADS score according to tissue MRS-based metabolomics. Metabolic differences between Target and contralateral cores, regardless if Targets were Ca-positive or not, support the assumption that targeted areas fundamentally and metabolomically differ from non-targeted areas.
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