Prostate cancer is the second most common cause of cancer deaths among males in the United States. Prostate screening by digital rectal examination and prostate-specific
antigen has shifted the diagnosis of prostate cancer to lower grade, organ confined
disease, adding to overdetection and overtreatment of prostate cancer. The new challenge
is in differentiating clinically relevant tumors from ones that may otherwise never have
become evident if not for screening. The rapid evolution of imaging modalities and the
synthesis of anatomic, functional, and molecular data allow for improved detection and
characterization of prostate cancer. However, the appropriate use of imaging is difficult
to define, as many controversial studies regarding each of the modalities and their utilities
can be found in the literature. Clinical practice patterns have been slow to adopt many of
these advances as a result. This review discusses the more established imaging
techniques, including Ultrasonography, Magnetic Resonance Imaging, MR Spectroscopy,
Computed Tomography, and Positron Emission Tomography. We also review several
promising techniques on the horizon, including Dynamic Contrast-Enhanced MRI,
Diffuse-Weighted Imaging, Superparamagnetic Nanoparticles, and Radionuclide
Scintigraphy.