Can magnetic resonance imaging solve the prostate cancer conundrum?

Abstract

The debate about prostate-specific antigen (PSA) testing for the diagnosis of prostate cancer continues to rage. The United States Preventive Services Task Force (USPSTF) and the equivalent Canadian body have both advised against PSA screening.1,2 On the other hand, many authoritative bodies, including the American Urological Association,3 the National Comprehensive Cancer Network (US), the American Cancer Society, the European Association of Urology,4 and our own Urological Society of Australia and New Zealand recommend that, instead of population-based screening, decisions about PSA testing of men aged 55–69 years should be shared by doctors and individual patients.

A diagnostic test, that can detect significant prostate cancer, but can exclude indolent disease, has therefore been desperately needed. Multiparametric magnetic resonance imaging (mpMRI) may turn out to be that test.