[Current role of MRI for the local staging of prostate cancer]

The management of prostate cancer represents a real clinical problem for its unknown natural history, and unpredictable outcome and prognosis. The stage is the most important prognostic variable of any tumor. The use of nomograms, such as Partin's tables, supplies important information for the evaluation of the local stage. Nevertheless, these methods have low reliability because they do not use anatomical information of the gland. The development of MRI techniques incorporating high-resolution anatomical evaluation of the prostate in conjunction with metabolic information (MRI spectroscopy) offer the imaging technique of choice for the staging of prostate cancer in selected patients candidates to curative surgery. Prostate MRI offers the most reliable evaluation of local and regional staging. Anyway, many studies have described a wide variability in the reliability of prostate cancer staging by MRI, indicating that MRI is not a perfect imaging test because it cannot detect microscopic involvement. The objective of this article is to evaluate the current role of prostatic MRI for prostate cancer staging, evaluating its advantages, limitations and future expectations.