Korean J Urol.  2015 May;56(5):337-345. 10.4111/kju.2015.56.5.337.

Current role of multiparametric magnetic resonance imaging in the management of prostate cancer

• Katelaris
• Bolton DM
• Weerakoon
• Toner L
• Katelaris
• Lawrentschuk N

• KMID: 2155312
• DOI: http://doi.org/10.4111/kju.2015.56.5.337

Abstract

The purpose of this review was to evaluate the current role of multiparametric magnetic resonance imaging (mp-MRI) in the management of prostate cancer (PC). The diagnosis of PC remains controversial owing to overdetection of indolent disease, which leads to overtreatment and subsequent patient harm. mp-MRI has the potential to equilibrate the imbalance between detection and treatment. The limitation of the data for analysis with this new technology is problematic, however. This issue has been compounded by a paradigm shift in clinical practice aimed at utilizing this modality, which has been rolled out in an ad hoc fashion often with commercial motivation. Despite a growing body of literature, pertinent clinical questions remain. For example, can mp-MRI be calibrated to reliably detect biologically significant disease? As with any new technology, objective evaluation of the clinical applications of mp-MRI is essential. The focus of this review was on the evaluation of mp-MRI of the prostate with respect to clinical utility.

Keyword

Diagnosis; Magnetic resonance imaging; Pathology; Prostatic neoplasms; Urology

MeSH Terms

*Disease Management
Humans
Magnetic Resonance Imaging/*methods
Male
Prostate/*pathology
Prostate-Specific Antigen/blood
Prostatectomy
Prostatic Neoplasms/*diagnosis/pathology/surgery
Prostate-Specific Antigen

Figure

• 

  Fig. 1 T2-weighted image demonstrating an area of low signal intensity in the right peripheral zone consistent with prostate cancer.

• 

  Fig. 2 A dynamic contrast enhancement image (A) and postcontrast washout curve (B) of a right peripheral zone lesion.

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  Fig. 3 A diffusion-weighted image (b value= 2,500) (A) and the corresponding apparent diffusion coefficient map (B) demonstrating Gleason 4+3 prostate cancer in the right peripheral zone.

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