Advanced prostate imaging: Correlating prostate anatomy with MRI and MRI/ultrasound fusion

Conventional imaging modalities that demonstrate anatomical information fail to yield accurate information for diagnosis, staging and selection of treatment or effective monitoring of prostate cancer. Fortunately this has changed with newer imaging techniques that focus on functional and metabolic imaging, providing quantitative information and allowing investigation into changes that occur at a cellular level in prostate cancer. Multiparametric MRI combines the anatomical and functional domains of imaging to achieve this goal. Currently, the histopathological diagnosis of prostate cancer is based on transrectal ultrasound-guided biopsy, which has limited sensitivity. Technical improvements in MRI have resulted in the use of MRI to target prostate biopsies. This chapter presents a perspective on the optimal role of multiparametric MRI in prostate cancer detection and its use in targeted biopsies.