Magnetic resonance imaging and magnetic resonance spectroscopic imaging of prostate cancer.

Magnetic resonance imaging (MRI) and magnetic resonance spectroscopic imaging (MRSI) are evolving techniques that offer noninvasive evaluation of anatomic and metabolic features of prostate cancer. The ability of MRI to determine the location and extent of the tumor and to identify metastatic spread is useful in the pretreatment setting, enabling treatment decision-making that is evidence-based. MRSI of the prostate gland expands the diagnostic assessment of prostate cancer through the detection of cellular metabolites, and can lead to noninvasive differentiation of cancer from healthy tissue. MRI/MRSI can also be used to evaluate both local and systemic recurrence, with endorectal MRI being capable of detecting local recurrence, even in patients with rising serum PSA level but no palpable tumor on digital rectal examination. Considering the benefits that MRI and MRSI have been shown to offer patients, the skills and technology required to perform these tests should be widely disseminated to make their routine use possible. Teamwork between members of radiology, pathology, urology and radiation oncology departments is essential in order to exploit these technologies fully.