Author Reply

Abstract

We would like to thank Dr. Albertsen for his comments, and we agree that understanding the theoretical and practical role of multiparametric prostate magnetic resonance imaging (mpMRI) in the setting of active surveillance is important. The active surveillance “roadmap” designed by the Michigan Urological Surgery Improvement Collaborative advocates 3 options to be performed within 6 months after initial biopsy in patients with known low-risk prostate cancer: repeat standard prostate biopsy, mpMRI, or genetic testing. 1 Michigan Urological Society Improvement Collaborative Active surveillance: roadmap for management of men with favorable-risk prostate cancer. http://musicurology.com/active-surveillance/Date accessed: March 21, 2018 Google Scholar , 2 Auffenberg G.B. Lane B.R. Linsell S. et al. A roadmap for improving the management of favorable risk prostate cancer. J Urol. 2017; 198: 1220-1222 Crossref PubMed Scopus (21) Google Scholar The goal of performing a confirmatory test is to document that the low-risk prostate cancer diagnosed on initial biopsy is truly reflective of the underlying disease burden (ie, exclude higher risk cancer undersampled on initial biopsy). 1 Michigan Urological Society Improvement Collaborative Active surveillance: roadmap for management of men with favorable-risk prostate cancer. http://musicurology.com/active-surveillance/Date accessed: March 21, 2018 Google Scholar , 2 Auffenberg G.B. Lane B.R. Linsell S. et al. A roadmap for improving the management of favorable risk prostate cancer. J Urol. 2017; 198: 1220-1222 Crossref PubMed Scopus (21) Google Scholar Which of these 3 confirmatory tests is optimal is unknown, and may vary by patient preferences, economic considerations, and clinical risk.