Abbreviated Biparametric MRI (RSI + T2WI) for Prostate Cancer Detection: Correlation With Histopathology

Primary Objective This is a prospective study of men presenting to MD Anderson with treatment naïve, histologically confirmed prostate cancer. The primary objective of this study is to compare the diagnostic accuracy of T2 weighted imaging (T2WI) and restriction spectrum imaging (RSI) (T2WI + RSI) to that of multiparametric MRI (mpMRI), for the detection of individual prostate cancer foci. Results will be validated against histopathologic findings at prostatectomy as the reference standard. We hypothesize that T2WI + RSI will detect more clinically significant prostate cancer foci (any Gleason grade group \> 2) compared to mpMRI when one-to-one matching between imaging and prostatectomy findings is performed. Secondary Objectives -To perform a pilot study evaluating T2WI+RSI/US fusion guided biopsy compared to mpMRI/US fusion biopsy for the diagnosis of clinically significant cancer (any Gleason grade group \> 2) in a cohort of patients scheduled for clinically indicated MRI/US fusion guided biopsy. In this pilot study, we hypothesize that RSI/US fusion guided biopsy will be non-inferior to mpMRI/US fusion guided biopsy in the detection of clinically significant prostate cancer. Primary Objectives: * To acquire high frequency transrectal microultrasound data in patients undergoing clinically indicated MRI/US fusion guided biopsy. * To perform additional comparative analyses of mpMRI and RSI images, including analyzing variations in tumor contours between imaging data sets.