Dynamic contrast-enhanced MR imaging in the evaluation of patients with prostate cancer

Prostate cancer is a common tumor among men, with increasing diagnosis at an earlier stage and a lower volume of disease because of screening with prostate-specific antigen (PSA). The need for imaging of the prostate stems from a desire to optimize treatment strategy on a patient and tumor-specific level. The major goals of prostate imaging are (1) staging of known cancer, (2) determination of tumor aggressiveness, (3) diagnosis of cancer in patients who have elevated PSA but a negative biopsy, (4) treatment planning, and (5) the evaluation of therapy response. This article concentrates on the role of dynamic contrast-enhanced MR imaging in the evaluation of patients who have prostate cancer and how it might be used to help achieve the above goals. Various dynamic contrast enhancement approaches (quantitative/semiquantitative/qualitative, high temporal versus high spatial resolution) are summarized with reference to the relevant strengths and compromises of each approach.