Multiparametric MRI: An opportunity for focal therapy of prostate cancer

Abstract Focal therapy of prostate cancer aims to target cancer containing areas of prostate while leaving surrounding native tissue preserved, thus decreasing the risk of complications seen in whole gland treatments like radical prostatectomy and external beam radiation therapy. However, an intrinsic obstacle to the widespread implementation of the focal therapy is the tendency of prostate cancer to exhibit multifocality. For this reason, it is of paramount importance to ensure accurate disease localization prior to recommending this treatment option to patients, in order to avoid missing potentially aggressive cancers. Prostate multiparametric-MRI has shown efficacy in accurately detecting prostate cancer, and in theory this could be applied to patient selection for focal therapy. In this review we aim to explore the key tenets of prostate cancer focal treatments, and present a case for multiparametric-MRI to be used in patient selection for focal therapy.