The Evolution of Prostate Multiparametric MRI and Its Application in Prostate Cancer Clinical Management

Prostate multiparametric MRI (mpMRI) is an indispensable diagnostic tool in the clinical management of patients suspected of prostate cancer (PCa). This mpMRI consists of T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced MRI (DCE-MRI). This review first outlines the importance of preparation techniques in mpMRI examinations and the evolution, current status, and latest technologies of these imaging techniques. It then addresses the clinical applications of diffusion tensor imaging, particularly its potential in surgical strategies for radical prostatectomy. Additionally, this review addresses the issues and clinical application potential of biparametric MRI, which omits DCE-MRI, in PCa diagnosis. It also discusses countermeasures for category 3 lesions with insufficient positive rates for clinically significant PCa in the Prostate Imaging-Reporting and Data System (PI-RADS) diagnostic criteria for prostate mpMRI, as well as the current status of MRI-ultrasound fusion guided prostate targeted biopsy in clinical practice using prostate mpMRI as a guide.