Comprehensive review of penile cancer using MR imaging

Magnetic resonance imaging (MRI) is considered the gold standard for staging penile squamous cell carcinoma and assessing its extent. However, due to the rarity of this pathology, few medical centers have regular experience with penis carcinoma imaging. The purpose of this article is to provide a comprehensive update on the role of MRI in penile cancer by reviewing the MRI anatomy of a normal penis, outlining the recommended MRI techniques for penis assessment, and discussing the benefits and drawbacks of artificial erection. We will also highlight how MRI can serve the purpose of tumor staging and its therapeutic consequences. CRITICAL RELEVANCE STATEMENT: To provide a comprehensive and practical review of penile cancer based on imaging, including epidemiology, prognosis, treatment, penile MRI protocol, anatomy, and key points for accurate analysis. KEY POINTS: Penile carcinoma affects the glans and/or the foreskin in 98% of cases. MRI is the most accurate imaging modality for staging penile carcinoma and assessing its extent. T2-weighted using thin section is the best sequence to identify the tumor. Accurate treatment depends on the depth of local invasion and lymph node involvement.