Consultant Radiologist, The Princess Grace Hospital
and University College, London
As prostate cancer, viewed on an MRI scan, is difficult to distinguish, its value in identifying the disease and monitoring the impact of treatment is too easily dismissed.
It does have a significant beneficial role to play, particularly as a functional imaging technique to:
- Localise cancer within the gland
- Differentiate between indolent and clinically significant disease
- Identify areas likely to represent aggressive disease
- Monitor the response to treatment
- Identify recurrent disease.
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Two MRI views of a normal prostate gland |
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Infections and non-cancerous diseases can mimic the appearance of cancer of the prostate in an MRI scan. Post biopsy and radiotherapy, dark areas can be seen that could be misleading but with Metabolite Imaging, Neovascularity and Diffusion Imaging, using MRI, cancer of the prostate can be diagnosed and localised for treatment.
Monitoring the gland's response to new minimally invasive treatments like HIFU allows assessment of its impact within weeks.
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Two MRI views of a prostate gland following HIFU treatment |
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As we continue to develop the value of MRI in the diagnosis, treatment and management of prostate cancer, in future it will play a wider role to include:
- Pre-biopsy
- Monitoring those on 'watchful waiting'
- Plan minimally invasive treatment
- DCE/spectroscopy/diffusion
- 3T
