Kukreja JB, Bathala TK, Reichard CA, et al. - Researchers examined how adding multiparametric MRI (mpMRI) to presurgical planning influence surgical decision making for the management of high-risk prostate cancer (HRPC). They performed a multiple center survey on surgical decisions of 41 consecutive HRPC cases. Surgical plan in regards to the degree of planned nerve-sparing and lymph node dissection were queried among six fellowship-trained urologic oncologists. They conducted two rounds of surveys with six external urologic oncologists; the first survey covered the case description only and the second covered case description with mpMRI images and report. Following mpMRI review, at least one change to surgical planning was made in all cases. The degree of planned nerve-sparing changed in 40 (98%) patients: wider excision in 32% and increased nerve-sparing in 24%. These observations suggest that mpMRI use influences surgical planning, cancer control, and quality of life although it is not integrated in guidelines for preoperative planning in HRPC.