Questions and answers on prostate multiparameter magnetic resonance imaging: Everything a urologist should know

Abstract Context For many years, the detection of prostate cancer (PC) and the management of its therapy have been based primarily on prostate-specific antigen, rectal examination and prostate biopsy. However, these parameters have known limitations. Multiparametric magnetic resonance imaging (mpMRI) for prostate cancer has undergone extensive development in recent years, providing morphological and functional information. The aim of this study is to present an updated review of the scope and limitations of prostatic mpMRI for PC, in the framework of a multidisciplinary vision. Acquisition of evidence We conducted a literature review (in PubMed) of articles referencing “mpMRI/staging/PC/detection/active surveillance/therapy planning/post-therapy”. We included 4 systematic reviews and other articles published in high impact-factor journals within the field of radiology and urology. Summary of the evidence MpMRI provides morphological and functional information concerning PC. This information is integrated into the Prostate Imaging Report and Date System, classifying the probability of clinically significant carcinoma on a scale from 1 to 5. The usefulness of mpMRI is currently being established for patients with high prostate-specific antigen levels and prior negative prostate biopsy; tumor staging in selected cases; assessment of patients who are candidates for active surveillance; the planning of focal treatments; and the assessment of tumor persistence and recurrence. Conclusions MpMRI currently fills a relevant role in the diagnosis and therapeutic decision-making of PC. More widespread use of the technique requires a cost/benefit analysis.