The detection MR examination includes at least two functional MR imaging techniques in addition to the anatomical information (Barentsz et al. 2012). Anatomical information can be obtained from T2-weighted imaging sequences (Figs. 10.2, 10.3, and 10.4), which are acquired in at least two planes (Barentsz et al. 2012). Preferably, axial and sagittal planes are chosen. T2-weighted MR imaging provides the best depiction of the prostate’s zonal anatomy and is the cornerstone of prostate MR imaging. Dynamic contrast-enhanced (DCE) MR imaging provides information about the perfusion and neovascularization of the prostate (Figs. 10.5 and 10.6). In both peripheral and transition zones, prostate cancer often demonstrates neovascularization; however, not all enhancing lesions are potential cancers. DCE-MR imaging is a very sensitive technique and lacks specificity. Benign prostatic hyperplasia, prostatitis, and scar tissue demonstrate similar enhancement patterns (Figs. 10.7, 10.8, and 10.9). Especially, prostatitis and low-grade prostate cancers are difficult to discern based on the DCE-MR imaging parameters (Fig. 10.10). Diffusion-weighted MR imaging (DWI) is a measure for the diffusion of water molecules. Restricted diffusion is seen in tissues with a high cellular density, such as prostate cancer. Apparent diffusion coefficient (ADC) values derived from DWI are related to prostate cancer aggressiveness (Hambrock et al. 2011; Kobus et al. 2011; Vargas et al. 2011; Turkbey et al. 2011). Considerable overlap in ADC values is seen in normal and cancerous tissue. Diffusion-weighted imaging shows differences between prostatitis and prostate cancer in both the peripheral zone and central gland, although its usability in clinical practice is limited as a result of significant overlap in ADCs (Nagel et al. 2013). Magnetic resonance spectroscopic imaging (MRSI) can be used to predict the presence or absence of prostate cancer; however, there is significant overlap in choline + creatine over citrate ratios between benign and malignant tissue. MRSI is performed with a three-dimensional chemical shift imaging technique (Fig. 10.11).