Prostate MRI: Detection, Staging, Biopsy Guidance, and Monitoring

Multiparametric MRI (mpMRI) is the premier imaging tool for prostate cancer.

Key Uses

• Detection: Identifies suspicious lesions (PI-RADS scoring).
• Staging: Assesses extracapsular extension, seminal vesicle invasion, lymph nodes.
• Biopsy Guidance: MRI-TRUS fusion targets lesions, improving clinically significant cancer detection.
• Active Surveillance Monitoring: Tracks lesion changes over time.
• Post-Treatment Surveillance: Detects recurrence after surgery/radiation.

Procedure

• Non-invasive, no ionizing radiation.
• Typically 30–45 minutes.
• May use endorectal coil (higher resolution) or surface coil.
• Contrast (gadolinium) often used for DCE-MRI.

Advantages

• High soft-tissue contrast.
• Reduces unnecessary biopsies.
• Improves risk stratification.

Limitations

• False positives (prostatitis, BPH).
• Cost/availability.
• Claustrophobia.