Functional magnetic resonance imaging and molecular pathology at the crossroad of the management of early prostate cancer.

Abstract

According to recent reports from randomized studies comparing radical treatment or watchful waiting, the outcome of localized prostate cancer remains uncertain at individual level. It is especially true for the low-risk group (according D'Amico or CAPRA classifications), regarding the individual exposition to overtreatment by radical therapies or the opposite risk of under-treatment with active surveillance. In this review, we describe the available molecular predictor tests and functional MRI, as well as their potential role in the selection of the appropriate treatment for prostate cancer patients. The recent development of functional MRI imaging and clinical practice approval of molecular predictor tests for the assessment of the aggressive prostate cancer have brought new perspectives for the management of localized prostate cancer by active surveillance, focal ablative therapy or radical therapies.