Active surveillance of prostate cancer with multiparametric magnetic resonance imaging: Review of the literature

Nowadays, active surveillance has gained popularity as an acceptable management alternative to definitive treatment for men with low-risk prostate cancer. Active surveillance aims to delay or prevent unnecessary interventions – thereby reducing the morbidity associated with overtreatment. Despite widespread acceptance from current guidelines, active surveillance does not eliminate the concern that the advanced disease and repeat biopsy anxiety for both the clinician and the patient. This situation leads to the search for a method that is non-invasive and can give an idea to the clinician about the status of the disease in the active surveillance protocol. Recent technological advancements and the introduction of modern anatomical and functional sequences have led to a growing role for multiparametric magnetic resonance imaging (mpMRI) in the detection, risk assessment, and monitoring of prostate cancer. The main advantages of MRI are its superior anatomic and contrast resolution, lack of ionizing radiation, and multi-planar capabilities. In addition, standardization of reporting findings such as PI-RADS in mpMRI in prostate cancer provides an advantage by increasing inter-reader reliability among radiologists. This study aims to evaluate and summarize the role of magnetic resonance imaging in the active surveillance of prostate cancer. Keywords: active surveilliance, prostate cancer, multiparametric magnetic resonance imaging