Korean J Urol.  2015 Jul;56(7):487-497. 10.4111/kju.2015.56.7.487.

Multiparametric magnetic resonance imaging for prostate cancer: A review and update for urologists

• Yoo S
• Kim JK
• Jeong IG

• KMID: 2160645
• DOI: http://doi.org/10.4111/kju.2015.56.7.487

Abstract

Recently, imaging of prostate cancer has greatly advanced since the introduction of multiparametric magnetic resonance imaging (mpMRI). mpMRI consists of T2-weighted sequences combined with several functional sequences including diffusion-weighted imaging, dynamic contrast-enhanced imaging, and/or magnetic resonance spectroscopy imaging. Interest has been growing in mpMRI because no single MRI sequence adequately detects and characterizes prostate cancer. During the last decade, the role of mpMRI has been expanded in prostate cancer detection, staging, and targeting or guiding prostate biopsy. Recently, mpMRI has been used to assess prostate cancer aggressiveness and to identify anteriorly located tumors before and during active surveillance. Moreover, recent studies have reported that mpMRI is a reliable imaging modality for detecting local recurrence after radical prostatectomy or external beam radiation therapy. In this regard, some urologic clinical practice guidelines recommended the use of mpMRI in the diagnosis and management of prostate cancer. Because mpMRI is the evolving reference standard imaging modality for prostate cancer, urologists should acquire cutting-edge knowledge about mpMRI. In this article, we review the literature on the use of mpMRI in urologic practice and provide a brief description of techniques. More specifically, we state the role of mpMRI in prostate biopsy, active surveillance, high-risk prostate cancer, and detection of recurrence after radical prostatectomy.

Keyword

Diagnosis; Magnetic resonance imaging; Prostatic neoplasms; Watchful waiting

MeSH Terms

Humans
Image Interpretation, Computer-Assisted/methods
Image-Guided Biopsy/methods
Magnetic Resonance Imaging/*methods
Male
Neoplasm Recurrence, Local/diagnosis
Practice Guidelines as Topic
Prostate/pathology
Prostatectomy
Prostatic Neoplasms/*diagnosis/surgery
Watchful Waiting

Figure

• 

  Fig. 1 A 72-year-old patient with prostate cancer. (A) On a picture of radical prostatectomy specimen, arrows indicate prostate cancer. (B) On T2-weighted imaging, prostate cancer shows slightly low signal intensity although the contrast between prostate cancer and adjacent normal tissue is not apparent. (C) On color-coded map of apparent diffusion coefficient, prostate cancer shows significantly decreased values, presented as dark blue color. (D) On initial area under the curve map derived from dynamic contrast-enhanced magnetic resonance imaging, prostate cancer shows increased vascularity, presented as yellow and green color.

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