Timo Soeterik

72 CHAPTER 4 CONCLUSIONS Use of mpMRI information for prostate cancer risk stratification leads to upstaging in one-third of the patients, mainly due to superior detection of non-organ-confined disease compared with DRE. Since mpMRI results in a higher overall diagnostic accuracy for the detection of non-organ-confined disease, it should be preferred over DRE for determining clinical tumour stage. However, due to its limited specificity for the detection of non- organ-confined disease clinicians should be aware that mpMRI can lead to overstaging and potential overtreatment of patients who harbor genuine low-risk disease.