Current Role of Magnetic Resonance Imaging in Prostate Cancer

© 2017, Springer Science+Business Media, LLC (Outside the USA). Purpose of review: Multiparametric magnetic resonance imaging of the prostate (mpMRI) is a new rising diagnostic modality in prostate cancer management. The combination of anatomic and functional sequences allows for detection, localization, and characterization of prostate cancer lesions. This leads to shift from staging to other clinical applications. However, lack of standardization of scanning, detection, and reporting protocols is a major drawback. Recent findings: Current main applications of mpMRI are detection, staging, and localization with the latter one enabling targeted biopsies of MRI-detected lesions. With this approach, more clinically significant and less insignificant cancer lesions are detected. This technique has the potential to help solving the dilemma of overdiagnosis of indolent cancers and underdiagnosis of potentially aggressive cancers. The Prostate Imaging Reporting and Data System version 2 (PI-RADSv2) is an attempt to establish more standardization in mpMRI. This new guideline could facilitate the clinical and scientific exchange among different institutions and therefore assist in gathering more multi-center evidence. Summary: Multiparametric magnetic resonance imaging of the prostate improves detection and staging of prostate cancer. In conjunction with targeted biopsy techniques, it allows for better characterization of the real tumor burden compared to template systematic biopsy. Potential future applications include active surveillance, detection of recurrence, metastasis and planning, and follow-up of focal therapy