Past, present and future magnetic resonance diagnosis of prostate cancer

After almost 40 years since the first-ever magnetic resonance imaging (MRI) of the prostate has been made the technology has made significant strides forward: dynamic contrast-enhanced imaging, diffusion weighted imaging and MR spectroscopy being a few among the others. Moreover, the development of high power magnets and phased array coils had contributed to the drastically improved quality of the imaging. These improvements have increased the detection quality for the clinically significant prostate cancer (PCa) and early recurrences, enabling physicians to create a more personalized treatment plan easier and quicker. PROMIS (the Patient-Reported Outcome Measurement Information System) 2017 and PRECISION (Prostate Evaluation for Clinically Important Disease: Sampling Using Image Guidance or Not) 2018 studies underline the importance of MRI in detecting clinically significant PCa and avoiding overly aggressive diagnostic of clinically insignificant PCa. A large number of articles devoted to analyzing the role of MRI in diagnosing PCa (localization and staging) do not come to a uniform conclusion. This can be, in part, explained by the different study designs and protocols, as well as other controllable factors in the MRI studies themselves. The goal of this article is to attempt to analyze the role of MRI in diagnosing PCa since its advent, through its' current stage of development, as well as to explore the forward looking scenarios and opportunities for this extremely useful imaging modality.