Staging Imaging for Focal Therapy of Prostate Cancer

Contemporary prostate imaging modalities serve a complementary role to the medical history, physical examination, serum prostate-specific antigen (PSA) levels, and prostate biopsy pathology in performing a complete staging work-up for localized prostate cancer. While transrectal ultrasound (TRUS) has served as the primary means for prostate imaging for decades, providing readily available, cost-efficient, real-time imaging to define basic prostate anatomy, the development and characterization of multi-parametric magnetic resonance imaging (mpMRI) and prostate-specific membrane antigen (PSMA) positron emission tomography (PET) imaging has fundamentally advanced how intraprostatic lesions are identified and how clinically localized prostate cancer is staged. Increased utilization of these imaging modalities has become essential for accurate characterization of disease burden when determining a patient’s candidacy for focal therapy to treat prostate cancer.