Over the last several years, MRI has assumed an important role in detection of cancer of the prostate gland. Primary care physicians screen their male patients for prostate cancer, usually beginning at the age of 40, with a simple blood test called PSA (Prostate Specific Antigen). However, this test is not specific for prostate cancer, as there are many other cause of an elevated PSA, including infection and enlargement of the prostate related to aging. In addition, a minority of patients with prostate cancer do not have elevation of their PSA.
Until recently, multiple biopsies of the prostate, accomplished through the rectum using ultrasound guidance, has been the only way to further investigate patients with high PSA and/or other high risk factors for prostate cancer. Now,” multiparametric” MRI of the prostate has become an important tool for investigating these patients.
Using multiple MR imaging parameters, this test can detect and localize prostate cancer, guide biopsy of the lesion, and detect spread of cancer in local tissues. At Radiology Associates of Ridgewood, we use our 3T (“high field”) MRI scanner for this purpose, allowing us to obtain very high resolution images of the prostate gland without the need to insert uncomfortable signal receiving coils into the rectum.
Reasons you might be referred for this examination include:
- A high or rising PSA level, either prior to a transrectal biopsy or after a transrectal biopsy that yielded negative results.
- You are in a high risk group for prostate cancer, even with a normal PSA.
- In newly diagnosed cases of prostate cancer, to establish whether disease has spread locally, thereby helping in the selection of the correct plan of treatment.
- A rising PSA level following surgery or other treatment of prostate cancer, to detect recurrence of disease.
- Known cases of prostate cancer who are on “active surveillance”.