Multiparametric MRI before and after Focal Therapy for Prostate Cancer: Pearls and Pitfalls for the Reporting...

Area of Science:

• Oncology
• Radiology
• Medical Imaging

Background:

• Personalized medicine drives interest in focal therapy for prostate cancer to minimize treatment morbidity.
• Multiparametric MRI (mpMRI) and targeted biopsy enhance detection of clinically significant prostate cancer.
• Post-focal therapy surveillance using mpMRI is essential for evaluating treatment efficacy.

Purpose of the Study:

• To review the role of mpMRI in prostate cancer focal therapy.
• To discuss mpMRI for pretreatment assessment, treatment planning, and post-focal therapy surveillance.
• To highlight challenges and standardized assessment systems for detecting recurrence after focal therapy.

Main Methods:

• Review of institutional experience with mpMRI before and after focal therapy.
• Discussion of common focal therapy modalities (cryotherapy, irreversible electroporation).
• Analysis of standardized assessment systems like PI-FAB and TARGET.

Main Results:

• Focal therapy offers a potential alternative to whole-gland treatment, reducing morbidity.
• Familiarity with post-treatment changes on mpMRI is critical for accurate interpretation.
• Standardized systems aid in detecting tumor recurrence and long-term surveillance.

Conclusions:

• mpMRI plays a vital role in the evolving field of prostate cancer focal therapy.
• Radiologists need expertise in interpreting mpMRI for patient selection, planning, and surveillance.
• Accurate mpMRI interpretation is key to assessing oncologic outcomes and managing recurrence.