Advances in Prostate Imaging: Implications for Prostate Cancer Diagnosis and Treatment

Prostate imaging can be accomplished with numerous techniques including computed tomography (CT), ultrasound, and magnetic resonance (MR) imaging. Each of these imaging tools relies on different physical properties of the tissue being evaluated to create an anatomic image. Ultimately, the goal of the numerous imaging strategies is to increase the conspicuity of the tumor, leading to improved diagnosis and staging. For the radiologist, the prostate gland presents challenges due to the simultaneous presence of normal tissue, and benign and malignant diseases that can produce very similar changes in the tissue characteristics on the CT scan, sonogram, and MR image. Distinguishing normal from diseased tissue or benign from malignant processes within the prostate gland is challenging when based solely upon anatomic images. Newer imaging techniques that focus on functional or metabolic imaging rather than simple anatomic changes may provide insight into prostate cancers by allowing us to investigate changes that occur in the ­prostate gland on a cellular level. A synthesis of high-resolution anatomic imaging with functional and metabolic imaging may provide new tools for understanding prostate cancer.