MRI for Prostate Cancer Local Staging: AJR Expert Panel Narrative Review

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Multiparametric MRI (mpMRI) is increasingly vital for prostate cancer staging and management.
• Current literature supports mpMRI's role in cancer detection and guiding treatment decisions.
• However, a universally accepted mpMRI staging framework is absent.

Purpose of the Study:

• To review current evidence on mpMRI for prostate cancer local staging.
• To highlight MRI features distinguishing organ-confined disease from advanced stages (EPE, seminal vesicle invasion).
• To explore structured reporting frameworks and address challenges in mpMRI staging.

Main Methods:

• Narrative review of existing literature on mpMRI for prostate cancer staging.
• Synthesis of evidence on MRI features for local staging.
• Exploration of proposed reporting frameworks for extraprostatic extension (EPE).

Main Results:

• mpMRI aids in identifying key features for local staging, including EPE and seminal vesicle invasion.
• Proposed structured frameworks for EPE reporting exist, using MRI alone or with clinical data.
• Variability in reproducibility and lack of standardization are noted challenges.

Conclusions:

• Standardization of mpMRI reporting and integration into international guidelines are crucial.
• Prospective studies are needed to validate mpMRI staging in clinical practice.
• Future advancements may involve radiomics, AI, and molecular imaging for enhanced prostate cancer staging.