With the advent of focal therapy as a recognized treatment option for men with prostate cancer, there are a host of emerging interventions that take advantage of MRI for image guidance. Focal therapy affords a middleground option for patients with low- to intermediate-grade prostate cancer by providing a means of keeping their cancer at bay while avoiding the negative consequences of radical therapies. However, the practice of focal treatment is far from straightforward, with some believing focal treatment errs on the side of overtreatment among patients with low-grade cancer; others worry it is undertreatment in potentially significant multifocal disease. Further research is necessary, both relating to focal therapy in general and to the utility of each MRI-guided focal treatment discussed.
Keywords: HIFU; MRI guidance; cryotherapy; focal laser ablation; focal therapy; irreversible electroporation; multiparametric MRI; prostate cancer.