[MRI and prostate cancer: a paradigm shift].

Area of Science:

• Radiology and Medical Imaging
• Oncology
• Urology

Context:

• Prostate magnetic resonance imaging (MRI) protocols have evolved significantly.
• Historically used for detecting extra-prostatic tumors, MRI is now integral to various stages of prostate cancer management.
• Current protocols utilize advanced imaging sequences and high-resolution coils at 1.5T and 3.0T.

Purpose:

• To define the evolving role of prostate MRI in clinical practice.
• To highlight the integration of morphological and functional imaging techniques.
• To identify key areas for improvement in MRI accessibility and standardization.

Summary:

• Prostate MRI is now employed for pre-biopsy diagnosis, treatment planning (e.g., prostate mapping), and post-treatment follow-up (evaluating recurrence after HIFU, radiation, or focal therapy).
• Imaging combines T2-weighted sequences with functional data from perfusion imaging, diffusion imaging, and spectroscopy.
• High-resolution phased array pelvic coils or combined endorectal coils enhance image quality.

Impact:

• Standardization of indications and protocols will improve clinician acceptance and patient access.
• Reducing costs and enhancing result reproducibility are crucial for broader implementation.
• Optimized prostate MRI contributes to more precise diagnosis, staging, and personalized treatment strategies for prostate cancer.