Abstract

More than many cancers, prostate cancer requires accurate imaging information to select the most appropriate treatment for individual patients and for assessing response to therapy. This is due to the pathologic and biologic complexity of the human prostate and prostate cancer. This complexity results in questions of whether and how to treat individual prostate cancer patients. Additionally, this complexity demands state-of-the-art high spatial resolution multiparametric MR imaging and spectroscopy techniques to accurately assess disease status in individual patients. Increasing numbers of published studies have shown that the ability to meet these complex prostate cancer imaging needs requires a combination of advanced anatomic and functional imaging approaches, including; 1H MRSI , diffusion weighted imaging, dynamic contrast imaging, quantitative T2-mapping, and by performing the imaging exam on higher magnetic field strength MR scanners. Additionally, an extraordinary new technique utilizing hyperpolarized 13C labeled metabolic substrates has the potential to revolutionize the way we use MR imaging in the clinical management of prostate cancer patients. In this lecture, the current clinical status of these advanced imaging techniques for the detection and characterization of prostate cancer prior to and after therapy will be concisely reviewed with an emphasis on the clinical utility of the resulting imaging information, and the obstacles that need to be over-come to establish advanced multiparametric prostate imaging as a routine clinical tool.