New horizons in genitourinary oncologic imaging.

In the management of prostate cancer, combined anatomic and metabolic imaging is already in clinical use. In daily clinical practice, fusion of magnetic resonance imaging and magnetic resonance spectroscopic imaging is improving the evaluation of cancer location, size, and extent and is simultaneously providing assessment of tumor aggressiveness. Pretreatment knowledge of these prognostic variables is essential if minimally invasive, patient-specific cancer therapy is to be achieved. This report discusses the changes that are occurring in oncologic imaging and in genitourinary oncologic imaging in particular. It presents an overview of the applications of magnetic resonance imaging and magnetic resonance spectroscopic imaging for prostate cancer that is intended to illustrate the evolution of state-of-the-art imaging in a clinical setting. It also provides a short review of molecular imaging probes from the field of ongoing prostate cancer research. It concludes with a broader discussion of the nature of molecular imaging and the benefits it offers for cancer research and clinical care, which include noninvasive, in vivo imaging of specific cellular and molecular processes, nearly simultaneous monitoring of multiple molecular events, real-time imaging of the trafficking and targeting of cells, optimal patient-specific adjustment of drug and gene therapy, and assessment of disease progression at a molecular pathologic level.