Prostate MRI and MRI-Guided Biopsies

Prostate MRI, Aytekin Oto, MD

The University of Chicago Medicine is one of the few hospitals in the nation that offers a full array of magnetic resonance imaging (MRI) methods to diagnose prostate cancer. With MRI, our physicians can create detailed images of the body without the use of radiation. In addition, with MRI-guided prostate biopsy and MRI/ultrasound fusion biopsy, our physicians now have more accurate techniques to locate and biopsy suspicious lesions, which greatly reduces the number of needle biopsies and lowers the chance for false negative test results.

Improved Diagnostic Accuracy

Current diagnostic tools, including PSA (prostate-specific antigen) screening, are unable to distinguish life-threatening prostate tumors from indolent, or slow growing, tumors. As a result, many patients at other institutions have received unnecessary, invasive prostate biopsies and aggressive therapy. At the University of Chicago Medicine, our goal is a definitive diagnosis. Prostate MRI is the best non-invasive tool for imaging cancer in the prostate because of its high soft-tissue contrast, multi-planar capabilities. MRI has the potential to provide unique functional and biologic information not available with other imaging technology.

By performing non-invasive evaluation of the entire prostate at the time of initial diagnosis, our experts can differentiate high-grade disease that requires aggressive treatment from slow-progressing cancer. MR prostate imaging allows us to accurately diagnose, perform local staging and detect recurrence of prostate cancer. With this information, our team can personalize treatment plans to meet individual patient's needs.

When to Consider Prostate MRI

In addition to initial diagnosis, MR imaging can be used to monitor and evaluate patients with prostate cancer, including providing critical information for the continued management of the disease, including:

  • Evaluation of elevated PSA before prostate biopsy or after initial negative biopsy: MRI can show the location of any existing cancer within the prostate.
  • Local staging of prostate cancer for patients who have intermediate risk disease: MRI can exhibit extracapsular invasion, seminal vesicle invasion or enlarged lymph nodes, which can influence the treatment options.
  • Triage and follow-up for patients undergoing active surveillance (AS): Approximately one-third of the patients who choose to undergo AS may eventually require additional treatment if more aggressive disease is detected. MRI delivers early detection, and can serve as a continued follow-up procedure for patients using AS to monitor disease status.
  • Providing information to help treat patients with elevated PSA: Elevated PSA is the initial sign of cancer recurrence after treatment (radiation or prostatectomy). MRI can identify the location of cancerous lesions (pelvis or metastatic) and the extent of the disease.
  • Providing information for focal therapy: Accurate localization of the cancer within the prostate using MRI is crucial for a successful focal treatment.

Prostate MRI is not right for everyone -- you and your physician will work together to decide the best course of action. Due to the strong magnetic field used to produce images, some patients with kidney disease or implanted devices, such as pacemakers, stents and inner ear implants may not be candidates for MRI procedures.