
Prostate MRI is a medical imaging technique that visualizes the prostate gland and its tumor microenvironment without invasive contrast agents.Multiparametric MRI (mpMRI) of the prostate combines several sequences: T2-weighted images show anatomy, diffusion-weighted images reveal cell density based on water molecule mobility, and dynamic contrast enhancement shows blood supply. Combined analysis allows distinguishing malignant tumors from benign changes with high probability.
The roots of MRI go back to 1938, when Isidor Rabi discovered nuclear magnetic resonance. In 1973, Paul Lauterbur obtained the first MR image, and in 1977, Peter Mansfield developed echo-planar imaging, speeding up scanning. For the prostate, the first studies appeared in the 1980s, but it was not until the mid-2000s that the multiparametric approach took shape. In 2012, the European Society of Urogenital Radiology (ESUR) introduced the standardized PI-RADS reporting system, revised in 2015 and 2019. Today, mpMRI is a key step in prostate cancer diagnosis, reducing the number of unnecessary biopsies and improving the detection of aggressive forms.
A high-strength magnetic field (1.5 or 3 T) aligns the nuclei of hydrogen atoms. A radiofrequency pulse excites them, after which they relax, emitting signals that are encoded by gradient fields and converted into an image. The T2-weighted sequence reflects differences in transverse relaxation time, showing anatomy: the normal peripheral zone is bright, cancer is dark. Diffusion-weighted imaging at different b-values is sensitive to Brownian motion of water; by calculating ADC, a map is obtained where areas of restricted diffusion (high cell density, typical of cancer) appear dark. Dynamic contrast enhancement tracks contrast uptake and washout, revealing zones of neoangiogenesis — tumors 'light up' in the early phases. Combined assessment using the PI-RADS scale minimizes subjectivity.
It is used for early detection of prostate cancer, biopsy planning, and monitoring disease progression, replacing random tissue sampling with a targeted approach.
Prostate MRI can detect cancer the size of a pea, which is impossible to feel with a finger, and helps avoid unnecessary biopsies in 30% of patients.























