MR-Guided Prostate Interventions

The introduction of PSA screening has resulted in dramatic stage migration such that the vast majority of prostate cancer is now diagnosed in a clinically localized stage. Earlier diagnosis of prostate cancer has resulted in superior oncologic outcomes using whole-gland therapies and has also presented opportunities for focal therapies which may limit the morbidity of treatment. Currently, multiparametric magnetic resonance imaging (mpMRI) has emerged as the gold standard for imaging localized prostate cancer and has enhanced image-targeted therapy of prostate cancer in both the primary and salvage settings. Use of mpMRI allows not only for treatment planning and guidance but also for real-time treatment monitoring and posttreatment evaluation. Here we review the characteristics of mpMRI as they pertain to prostate imaging and explore the use of MRI in targeted interventions for prostate cancer.