Regarding the Focal Treatment of Prostate Cancer: Inference of the Gleason Grade From Magnetic Resonance Spectroscopic Imaging

In patients with biopsy Gleason score ≥4+3, high MRS imaging tumor volume and (creatine + choline)/citrate ratio may justify the initiation of voxel-specific dose escalation. This is an example of biologically motivated focal treatment for which intensity-modulated radiotherapy and especially brachytherapy are ideally suited.