Magnetic resonance imaging-guided functional anatomy approach to prostate brachytherapy

Purpose To provide an MRI based functional anatomy guide to prostate brachytherapy. Methods and Materials We performed a narrative review of periprostatic functional anatomy and the significance of this anatomy in prostate brachytherapy treatment planning. Results MRI has improved delineation of gross tumor and critical periprostatic structures that have been implicated in toxicity. Furthermore, MRI has revealed the significant anatomic variants and the dynamic nature of these structures that can have significant implications for treatment planning and dosimetry. Conclusions The MRI-based functional anatomy approach to prostate brachytherapy takes into account extent of disease, its relation to the patient's individual anatomy, and functional baseline to optimize the therapeutic ratio of prostate cancer treatment.