Imaging of the Prostate
Living with prostate cancer isn’t easy. And talking about it isn’t any easier. If you or someone you love has a high PSA level, then your doctor may recommend that you get a prostate biopsy or a prostate MRI.
The prostate is the male reproductive system’s organ, which is located in the pelvis in front of the rectum and between the bladder and penis. The prostate releases semen, the fluid that transmits sperm from the testicles out of the body. As men reach middle age, their risk for prostate problems increases because the prostate gland tends to grow larger with age.
Regular screening tests such as a PSA test may help to detect prostate cancer at an early stage when it is less likely to have spread and may be easier to treat. High levels of PSA may indicate the presence of cancerous tissue and you may need to undergo further tests such as a prostate MRI and a prostate biopsy.
What is a Prostate MRI
A prostate MRI generates a magnetic field and uses radio waves to form a visual rendition of what is happening around your prostate region. The MRI will produce three-dimensional images that cannot be obtained from an X-ray, ultrasound, or CT scan. It’s completely safe and you won’t feel a thing.
In prostate cancer patients, MRI is used to diagnose the prostate conditions and nearby lymph nodes to differentiate between benign (noncancerous) and malignant (cancerous) sites. The prostate MRI examination poses no risk to the patient if prescribed safety guidelines are followed.
Prostate MRI is used:
- To look for cancer in the prostate
- To help the doctor see the prostate during certain procedures (like a prostate biopsy or certain kinds of prostate cancer treatment)
- To look for the spread of prostate cancer to other parts of the body
It can be used to help know if a man with an abnormal screening test or with symptoms that might be from prostate cancer should get a prostate biopsy.
Prostate Biopsy v Prostate MRI
A prostate biopsy uses a needle to collect sample tissue from your prostate gland. These samples are then examined under a microscope to determine if there are any signs of prostate cancer and ascertain whether the tumors are benign or malignant. The needle is either inserted through the wall of the rectum or through the perineum (between anus and scrotum).
Some doctors are of the opinion that a prostate MRI should be performed before a biopsy because a prostate MRI can accurately identify whether patients even need a biopsy. Studies have also shown that a prostate MRI can often identify prostate cancer in patients whose initial biopsies were negative. In some cases, all that is needed is a prostate MRI before determining treatment options.
The temporary side effects of a prostate biopsy can include infection, blood in urine and semen, difficulty urinating, and sexual dysfunction. Not to mention that a biopsy is painful so it’s often better to get an MRI first before proceeding with a biopsy.
How is a Prostate MRI performed?
Prior to the date of your exam, you will receive specific instructions on how to prepare. Before the test begins, you will be asked a series of questions about whether you have any metal implants, such as artificial joints, or electronic devices, such as pacemakers, inside you.
You will then be asked to change into a hospital gown and lie on a table attached to the MRI machine. A small needle will be inserted into a vein in your arm or hand; this will be used to give the following medications:
- Buscopan, which helps to reduce the movement of the bowel. Bowel movement during the scan can affect the quality of the images of the prostate gland. The images must be as clear as possible.
- Gadolinium contrast medium (see Gadolinium contrast medium item), sometimes just called ‘contrast’, can help show any cancer in the prostate gland. Not every radiology practice will use a contrast medium.
The Gadolinium contrast helps the radiologist see the prostate and other organs more clearly on the scan. It is usually safe but can sometimes cause problems if you have kidney problems or a previous allergy to contrast media. Let the radiographer know if you have either of these issues prior to commencing your exam.
During the exam, the machine won’t touch you, but it can noisy, and you might feel warm. Our team will provide you with earplugs or headsets to block out most of the noise.
The scan takes 30 to 40 minutes.
After the exam, you can carry out your usual activities as normal.
After Your Prostate MRI
Your doctor or a radiologist will analyze the results of your prostate MRI and then proceed to recommend what you should do next. Treatment options will be reviewed if necessary.
Follow-up exams may be needed if a potential cell abnormality is detected. Sometimes special imaging techniques are required for more in-depth evaluation.
There is always the possibility that after a period of time, a follow-up exam may show a change in your condition.
Your MRI scan images will be examined based on PI-RADS (Prostate Imaging – Reporting and Data System) score or your Likert score.
- PIRADS or Likert score 1: It’s very unlikely that you have prostate cancer that needs to be treated.
- PIRADS or Likert score 2: It’s unlikely that you have prostate cancer that needs to be treated.
- PIRADS or Likert score 3: It isn’t possible to tell from the scan whether you have prostate cancer that needs to be treated.
- PIRADS or Likert score 4: You likely have prostate cancer that needs to be treated.
- PIRADS or Likert score 5: You likely have prostate cancer that needs to be treated.
Prostate MRI at Akumin
Akumin offers prostate MRI exams at many of its centers. Complete the form below to schedule an appointment at a center closest to you. If you have had a prostate MRI performed with us, you can view your results on our patient portal within 24 to 48 hours after the exam.