Spotlight on multiparametric magnetic resonance imaging in prostate cancer management: current perspectives

Abstract

Clinical behavior of prostate cancer, the most common noncutaneous cancer in men, ranges from a nonsignificant indolent tumor to an aggressive cancer. Prostate cancer is subject to overdiagnosis and overtreatment, making screening, diagnosis, and treatment planning a controversial issue. Recently, even noninvasive simple screening methods such as prostatespecific antigen level and digital rectal examination are no longer recommended for screening as it has resulted in no reduction in mortality. Diagnosis and further treatment planning, however, are still based on a random transrectal ultrasound-guided biopsy, an invasive method with controversial efficacy that has been deemed as unnecessarily revealing nonsignificant tumors. Magnetic resonance (MR)-based techniques are emerging that provide noninvasive tools that are promising in the detection of clinically significant lesions and accurate staging. Moreover, MR imaging improves the performance of image-guided procedures, both in diagnosis and therapy. We focus here on recent advances in multiparametric MR imaging in prostate cancer diagnosis and provide a brief overview of other emerging techniques.