A multiparametric prostate MRI scan (mpMRI) is an advanced form of computer imaging which looks in detail at the prostate and surrounding areas. This is performed in conjunction with your prostate biopsy to give you the most accurate possible diagnosis and staging.
Multiparametric MRI is a relatively new technology, before this there was no reliable method for imaging prostate cancer. It is very sensitive and can detect up to 90% of significant prostate cancers. Given the technology is not 100%, it still needs to be performed along with a biopsy. The combination of the two gives us the best possible information to help you make an informed decision about treatment. It is generally performed before your biopsy, as the swelling that occurs after a biopsy makes the MRI more difficult to interpret.
The first advantage of a mpMRI is that if your biopsy shows no cancer, a normal mpMRI scan is very reassuring and makes a second biopsy less likely.
If a small amount of low grade cancer is found on biopsy, a mpMRI helps us decide whether active surveillance or radical treatment is best. A normal appearance on mpMRI reassures us that the cancer is likely low risk and active surveillance is a good option. If a large tumour is seen on mpMRI, this suggests that the biopsy may have missed a more aggressive tumour and active treatment may be more appropriate.
If surgery is planned for a more aggressive tumour, the mpMRI assists with planning of the operation and helps us decide whether nerve sparing is a suitable option, or whether the lymph glands of the pelvis should be removed along with the prostate.
The MRI is essentially a high powered magnet and is not suitable for any patient with metal objects in their body. This includes:
- joint replacements
- pacemakers or internal defibrillators
- neurosurgical clips
- any orthopaedic nails, plates or screws
- metal fragments in the eye