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Whole‐body magnetic resonance imaging for prostate cancer assessment: Current status and future directions

Over the past decade, updated definitions for the different stages of prostate cancer and risk for distant disease, along with the advent of new therapies, have remarkably changed the management of patients. The two expectations from imaging are accurate staging and appropriate assessment of disease response to therapies. Modern, next‐generation imaging (NGI) modalities, including whole‐body magnetic resonance imaging (WB‐MRI) and nuclear medicine (most often prostate‐specific membrane antigen [PSMA] positron emission tomography [PET]/computed tomography [CT]) bring added value to these imaging tasks. WB‐MRI has proven its superiority over bone scintigraphy (BS) and CT for the detection of distant metastasis, also providing reliable evaluations of disease response to treatment. Comparison of the effectiveness of WB‐MRI and molecular nuclear imaging techniques with regard to indications and the definition of their respective/complementary roles in clinical practice is ongoing. This paper illustrates the evolution of WB‐MRI imaging protocols, defines the current state‐of‐the art, and highlights the latest developments and future challenges. The paper presents and discusses WB‐MRI indications in the care pathway of men with prostate cancer in specific key situations: response assessment of metastatic disease, “all in one” cancer staging, and oligometastatic disease.