Interpreting Prostate Multiparametric MRI: Beyond Adenocarcinoma - Anatomical Variations, Mimickers, and Post-Intervention Changes

Semin Ultrasound CT MR. 2025 Feb;46(1):2-30. doi: 10.1053/j.sult.2024.11.001. Epub 2024 Nov 22.

Abstract

Prostate magnetic resonance imaging (MRI) is an essential tool in the diagnostic pathway for prostate cancer. However, its accuracy can be confounded by a spectrum of noncancerous entities with similar radiological features, posing a challenge for definitive diagnosis. This review synthesizes current knowledge on the MRI phenotypes of both common and rare benign prostate conditions that may be mistaken for malignancy. The narrative encompasses anatomical variants, other neoplastic processes, inflammatory conditions, and alterations secondary to medical interventions. Furthermore, this review underscores the critical role of MRI quality in diagnostic accuracy and explores the emerging contributions of artificial intelligence in enhancing image interpretation.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma* / diagnostic imaging
  • Diagnosis, Differential
  • Humans
  • Image Interpretation, Computer-Assisted / methods
  • Male
  • Multiparametric Magnetic Resonance Imaging* / methods
  • Prostate* / diagnostic imaging
  • Prostatic Neoplasms* / diagnostic imaging