Cartography-based quality control of prostate cancer care: a necessary ground to targeted focal therapy.

PURPOSE OF REVIEW: We summarize the evidence on accurate target definition, precise imaging, and guiding systems that are a necessary ground to targeted focal therapy.

RECENT FINDINGS: Accurate target detection is based on the ability of imaging to locate and characterize precisely the tumor burden and differentiation inside the prostate. There is a clear correlation with the multiparametric MRI (mpMRI) images and the morphologic attributes of the tumor. Limitations stem from the heterogeneity and the multifocality of prostate cancer. Some prostate cancers are MRI-negative tumors. Safety margins should also be elaborated based on the tumor grade and burden. PET prostate specific membrane antigen is another promising technology yielding same results as multiparametric MRI for primary detection of prostate cancer, but PET/MRI imaging is promising. Perfect guiding requires sophisticated software with good quality control to track the needle inside the prostate and to record the position allowing recall when second look biopsy, active surveillance, or targeted focal therapy are required.

SUMMARY: The multimodal fusion cartography model proves effective and necessary to fulfill preoperative and postoperative requirements for targeted focal therapy.