Magnetic Resonance Imaging for Patient Selection for Focal Therapy

Magnetic resonance (MR) imaging (MRI) has become more useful for the workup and follow-up of prostate cancer, with the addition of new techniques (diffusion-weighted MR imaging, dynamic contrast-enhanced MRI, and MR spectroscopy) and technological advances (improvement in coil design and 3-T imaging systems). A vital key to the success of selective focal ablation of the prostate is proper patient selection. MRI has to assess the prostate volume and exclude patients with high-risk cancer that would be inappropriate for focal therapy. Indeed, MRI has the potential to provide information about volume, location, aggressiveness and local extension of prostate cancer. Before treatment it allows the characterization of a cancer already diagnosed by biopsy and guide target biopsy protocol if necessary. MRI is also useful to plan and implement focal treatment and to monitor for cancer recurrence and progression.