Role of Prostate MRI for Postfocal Treatment Assessment and Surveillance

This chapter provides a comprehensive review of the role of multiparametric MRI (mpMRI) in the assessment and surveillance of prostate cancer (PCa) following focal therapy (FT). FT, including high-intensity focused ultrasound, focal laser ablation, irreversible electroporation, focal cryotherapy, and photodynamic therapy, has emerged as promising minimally invasive treatment options for localized PCa. However, the accurate evaluation of treatment response and detection of disease recurrence post-FT remain challenging. mpMRI offers capabilities in visualizing posttreatment changes, detecting residual or recurrent disease, and guiding subsequent clinical management decisions. This chapter examines the latest evidence regarding mpMRI findings in post-FT PCa patients, exhibits the findings on the diagnostic accuracy of mpMRI in detecting recurrent disease, and discusses potential limitations and future directions in this evolving field.