Although the use of CT and MRI has improved in vivo localization of extraprostatic disease that is associated with higher risk of prostate-specific antigen (PSA) or biochemical recurrence (BCR) or metastasis, substantial weight is given to the volume and extent of dedifferentiation of PCa visualized on needle biopsies for assessing individualized risk (3). The gene discussed is KLK3; the disease is posterior cortical atrophy.