Anatomy of the Prostate and Periprostatic Region: A Contemporary Review, From the AJR Special Series on Critical Anatomy

MRI of the prostate has become an essential examination in the management of prostatic disease. This Special Series Review provides a clinically oriented update of the imaging anatomy of the prostate and adjacent structures, focusing on considerations relevant to radiologists interpreting prostate imaging, particularly MRI. Fundamental concepts in prostatic and periprostatic anatomy are presented, exploring in-depth anatomic structures as they relate to three major clinical contexts in which the prostate is imaged: prostate cancer, benign prostatic hyperplasia (BPH), and infection. In the setting of prostate cancer, detection and staging of disease should provide information to allow disease localization and extent to determine the best treatment strategy-including surgery, radiation therapy, and ablative techniques. For BPH, the size of the gland and the lobar origin of BPH nodules are helpful in selecting appropriate therapy. For infection, it is important to recognize potential overlapping imaging features between prostatitis and prostate cancer. Knowledge of prostatic and periprostatic cystic lesions is also important to avoid confusion with an abscess. Radiologists must refer to structures with appropriate anatomic nomenclature to facilitate communication with other practitioners involved in the care of patients with prostatic disease.