RESUMEN
La resonancia magnética multiparamétrica—la técnica de imagen más precisa para la detección del cáncer de próstata—ha transformado el panorama del diagnóstico del cáncer de próstata al permitir biopsias dirigidas. En una biopsia dirigida, se obtienen muestras de tejido de regiones sospechosas identificadas en la resonancia magnética diagnóstica previa a la biopsia. Los autores comparan brevemente las diferentes estrategias disponibles para dirigir una lesión sospechosa visible en la resonancia magnética, seguidas de una descripción paso a paso del enfoque directo guiado por resonancia magnética en el bore y una revisión ilustrada de su aplicación en escenarios clínicos desafiantes. En esta técnica, la visualización directa de la aguja, el guía de aguja y la trayectoria de la aguja durante el procedimiento proporciona una estrategia precisa y versátil para muestrear con precisión lesiones sospechosas, mejorando la detección de cánceres clínicamente significativos.

ABSTRACT
Multiparametric MRI—the most accurate imaging technique for detection of prostate cancer—has transformed the landscape of prostate cancer diagnosis by enabling targeted biopsies. In a targeted biopsy, tissue samples are obtained from suspicious regions identified at prebiopsy diagnostic MRI. The authors briefly compare the different strategies available for targeting an MRIvisible suspicious lesion, followed by a step-by-step description of the direct MRI-guided in-bore approach and an illustrated review of its application in challenging clinical scenarios. In this technique, direct visualization of the needle, needle guide, and needle trajectory during the procedure provides a precise and versatile strategy to accurately sample suspicious lesions, improving detection of clinically significant cancers.

ABSTRACT
Multiparametric MRI—the most accurate imaging technique for detection of prostate cancer—has transformed the landscape of prostate cancer diagnosis by enabling targeted biopsies. In a targeted biopsy, tissue samples are obtained from suspicious regions identified at prebiopsy diagnostic MRI. The authors briefly compare the different strategies available for targeting an MRIvisible suspicious lesion, followed by a step-by-step description of the direct MRI-guided in-bore approach and an illustrated review of its application in challenging clinical scenarios. In this technique, direct visualization of the needle, needle guide, and needle trajectory during the procedure provides a precise and versatile strategy to accurately sample suspicious lesions, improving detection of clinically significant cancers.