Advances in Medical Imaging Technology for Accurate Detection of Prostate Cancer

Prostate cancer (PCa) is the most frequently diagnosed non-cutaneous male malignancy and one of the leading causes of cancer-related mortality in the United States. Biologic heterogeneity of PCa results is different presentations ranging from indolent to highly aggressive tumors with high morbidity and mortality. Due to this broad range of clinical behavior, it is required to differentiate clinically significant PCa (csPCa) tumors and reduce detection of indolent cancers. PCa is generally diagnosed with non-targeted systematic trans-rectal ultrasound (TRUS)-guided biopsy in patients with elevated prostate serum antigen (PSA) or abnormal digital rectal examination (DRE). Non-targeted systematic TRUS as the typical imaging modality for assessing the prostate, samples only a small part of the gland with a high possibly that the biopsy results may not catch the most aggressive tumor in the gland accurately. Multi-parametric (MP) magnetic resonance imaging (MRI), as the most specific and sensitive imaging modality in PCa management, has been reported to be the reference standard for prostate imaging endorsed. However, there are a variety of interpretive pitfalls, which have been reported to be encountered at mpMRI of the prostate. The purpose of this chapter is to provide a summary of the cur - rent advances in accurate detection of PCa.