Diagnosis and Treatment of Prostate Cancer by Multiparametric MRI

Introduction: Prostate cancer (PCa) is the second leading cause of cancer-related mortality and the most frequently diagnosed male malignant disease among men in the world. On the other hand, understanding the limitations of tumor detection, particularly in multifocal disease, is important in its clinical application. Scientific work supports the rapidly growing use of multiparametric magnetic resonance imaging (mp-MRI) as the most sensitive and specific imaging tool for detection, lesion characterization and staging of PCa. Use of mp-MRI is likely to increase, and further developments in the technique will be important for safe adoption of focal therapy concepts.Methods: To quantify MRI enhancement characteristics of normal and abnormal prostatic tissues and to correlate these with tumor stage and histological grade. Materials and Methods: The articles in this review were based on evaluating the detection accuracy of mp-MRI in prostate cancer. The words Magnetic resonance imaging, Prostate, Cancer and MRI were searched on Google scholar and Scopus. Then related articles were reviewed in recent years and all studies were approved by the Local Committee for Health Research Ethics (No.H-1-2011-066). Results: The development of mp-MRI offers new possibilities in detection, lesion characterization and staging of PCa due to its high resolution and soft-tissue contrast. It also detects significant prostate tumors more accurately than conventional biopsies alone. Now the limitations of conventional MRI include the lack of information on tumor grade or vascularity, both of which are known to be useful predictors of patient prognosis. Mp-MRI can provide information about the morphological, metabolic and cellular changes in the prostate as well as characterize tissue vascularity and correlate it to tumor aggressiveness. Mp-MRI includes high-resolution anatomical T2-weighted (T2W) and T1-weighted (T1W) images in combination with one or more functional MRI techniques such as diffusion-weighted imaging (DWI) and dynamic contrast enhanced (DCE) imaging. Conclusion: Mp-MRI prior to repeated biopsies can improve the detection rate of clinically significant PCa. Mp-MRI can provide valuable information about the histopathological aggressiveness of a PCa lesion and the tumor stage.

Keywords:

Multiparametric magnetic resonance imaging , Prostate cancer , MRI , Conventional Biopsy