Current Applications and Future Directions of Artificial Intelligence in Prostate Cancer Diagnosis: A Narrative Review

Prostate cancer (PCa) remains a major global health challenge, yet conventional diagnostic methods are often limited by suboptimal accuracy and efficiency. Artificial intelligence (AI) has emerged as a rapidly developing technology capable of integrating multi-source data to enhance clinical decision-making. This narrative review synthesizes current evidence regarding AI applications across key diagnostic domains, including medical imaging, digital pathology, liquid biopsy, and multi-omics integration. Findings indicate that AI models for magnetic resonance imaging (MRI) can improve risk stratification and may reduce unnecessary biopsies in some cohorts, particularly when evaluated alongside structured radiology assessment and clinical variables. In digital pathology, deep learning algorithms have shown high agreement with expert genitourinary pathologists for automated Gleason grading in controlled and externally validated settings, with potential to reduce reporting time for high-volume workflows. Additionally, AI-powered liquid biopsy models may support non-invasive risk stratification, particularly for patients with prostate-specific antigen (PSA) levels in the diagnostic gray zone, while multi-omics integration is being investigated to enhance personalized assessment. Despite advances, challenges regarding data heterogeneity, algorithm interpretability, and workflow integration persist. Future research should prioritize multimodal data fusion, explainable AI development, robust calibration and decision-analytic evaluation, and large-scale prospective validation to standardize protocols and fully realize the potential of AI in precision prostate cancer care.