Multiparametric magnetic resonance imaging in the active surveillance of prostate cancer: protocol, risk stratification, and surveillance

Active surveillance serves as a vital management strategy for patients diagnosed with low-risk, organ-confined prostate cancer and is aimed at reducing overtreatment, cost minimization and enhancing patients' quality of life. However, the comprehensive implementation of active surveillance faces various challenges necessitating improvement, such as refining screening criteria, optimizing surveillance procedures, and establishing clear guidelines for active intervention. Multiparametric magnetic resonance imaging (mp-MRI) has assumed an increasingly pivotal role in the context of active surveillance. It provides essential supplementary insights into the identification and characteristics of prostate cancer. mp-MRI improves the precision of risk stratification, thus enhancing patient selection and compliance. Furthermore, it facilitates continuous disease monitoring, thereby reducing the probability of missed treatment opportunities during follow-up. This review, characterized by its meticulous analysis, aims to comprehensively examine the utilization and advancements of mp-MRI in the active surveillance of prostate cancer.