ABSTRACT
The American Urology Association recommends screening for prostate cancer in men aged 55–70 who are without risk factors or family history. Screening involves a digital rectal exam and serum prostate-specific antigen, the combination of which helps to provide a level of risk of prostate cancer to the patient. Magnetic resonance imaging (MRI) was first utilized in 1977. Since its inception, the ability for MRI to detect and stage malignancy has been further refined and explored. Magnetic resonance spectroscopic imagingrelies on elevated choline and lower citrate in cancerous as opposed to benign tissue. Intermediate-risk patients may benefit more from information on disease location, such as the presence or absence of extraprostatic extension, to aid decision making on nerve-sparing and surgical approach. The so-called cognitive fusion or visual registration approach relies mostly on operative ability to use anatomic landmarks on ultrasound and MRI to manually guide the needle into the MRI-identified lesions.
