Is MRI Guided Biopsy the standard for PI-RADS category 4?

Hi, my father just had an MRI of his prostrate done recently.

Could any one chime on weather MRI-Guided (Fusion) is the standard of care for doing a biopsy based on this report?

Here is the report's text:

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Other Lesions #: Linear hypointense bands without restricted diffusion are seen in the posterolateral peripheral zone on the right in the mid gland – PI-RADS 2.

Neurovascular bundle: Not involved.

Seminal vesicles: Not involved.

Lymph nodes: No lymphadenopathy.

Bones: No osseous metastases detected.

Other pelvic organs: Normal.

IMPRESSION:

➢ Prostate enlargement with changes of benign prostatic hyperplasia.

➢ Lesion in the left anterior transition zone in mid-gland region represent PI-RADS category 2 – low (clinically significant cancer is unlikely to be present). These findings are also noted in the stroma-rich BPH nodule.

➢ Lesion in the left posteromedial peripheral zone in apex region represent PI-RADS category 4 – high (the presence of clinically significant cancer is likely present).

Patchy subtle linear hypointense areas on T2W images in the right peripheral zone without obvious focal nodule, restricted diffusion or abnormal early enhancement. These changes could either represent chronic prostatitis – PI-RADS category 2.

Overall PI-RADS category 4.

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