Utility of serum biomarkers for prostate cancer diagnosis in the magnetic resonance imaging era

The discovery of prostate-specific antigen (PSA) as a biomarker in prostate cancer has enriched the field of uro-oncology, offering valuable insights for disease monitoring, management decisions and surveillance for recurrence. However, when used for diagnosis, PSA suffers from limited specificity, which leads to excessive biopsies and overdiagnosis. Extensive studies have been conducted to identify novel biomarkers, ranging from single proteins to multivariate panels and the emerging field of liquid biopsies, which may offer better diagnostic performance in prostate cancer. In recent years, with the development of newer prostate biopsy techniques, such as magnetic resonance imaging (MRI)-ultrasound fusion biopsy, there has also been increasing recognition of the value of multiparametric MRI (mpMRI) in the diagnosis of prostate cancer. This article reviews current knowledge on the role of key serum biomarkers in prostate cancer diagnosis in an era where MRI is increasingly taking the spotlight.