Prostate cancer consists the most common cause of cancer in the adult male population. Its early diagnosis is the most essential way to treat and cure it. For this reason the annual check of the prostate-specific antigen (PSA) has been established for men after the age of 50 years. The diagnosis of prostate cancer is performed with transrectal biopsies with ultrasound guidance. In the last years it is obvious that this method has some disadvantages:
- It is an invasive method with, even a slight, possibility of complications.
- The biopsies are randomly taken, which results to damages in the areas the biopsy needle cannot reach, as it is possible that the repeated obtaining of biopsies is needed.
- Well differentiated and small lesions are diagnosed, which have no clinical importance and no treatment is required for them.
- There are patients with aggressive tumors, which are underdiagnosed. In these cases the multiparametric magnetic resonance imaging of the prostate, shows with precision the suspicious areas so that the obtaining of a most targeted biopsy can follow.
Polyparametric magnetic resonance imaging is a bloodless and easy method for the diagnosis of prostate cancer. It is systematically applied globally since 2012, after the publication of specific guidelines by the European Society of Urogenital Radiology regarding the way this examination should be performed and assessed. In the last five years, it has been certified that the multiparametric magnetic resonance imaging of the prostate is very useful and accurate. Its advantages, synergistically with traditional methods, such as the PSA control, the transrectal biopsies and the digital rectal examination are obvious, because:
- it is a bloodless test
- it does not image well differentiated damages/lesions, that have no clinical importance and do not require treatment, only monitoring
- it shows very accurately aggressive tumors, that need to be immediately treated
THEREFORE, WITH MAGNETIC RESONANCE IMAGING
- Patients with minor unimportant prostate damages that require only monitoring avoid useless and painful treatments.
- The transrectal biopsies after MRI are targeted in the area of the tumor with higher chances of success.
- The treatment of patients is planned with highest accuracy, because the extension of the disease is imaged in detail.
FIGURES Male, 55 years old, presented a gradual increase of the PSA levels with the latest value being 11ng/ml. He had undergone four transrectal biopsies, that were negative.
Figure 1 
Figure 2 
Figure 3
In Figures 2 and 3 the tumor in the anterior part of the prostate is marked, which has been diagnosed with the use of multiparametric magnetic resonance imaging. Based on this test, the patient underwent a new targeted biopsy in the area of the tumor, where moderately differentiated cancer has been found (Gleasonscore 7).