MRI’s role in avoiding unnecessary biopsies for detecting prostate cancer

There was a time when any man with an abnormally high prostate-specific antigen (PSA) level would be advised to have a biopsy making the determination of prostate cancer or not. The PSA is not 100% accurate and if the results suggest possibly cancer, further tests will be needed to confirm the diagnosis.

The test most often used is a prostate biopsy. A prostate biopsy relies on guidance from an ultrasound helping urologists retrieve random tissue samples from the prostate.  But using ultrasound for detecting prostate cancer has limitations. The main obstacle is the fact that an ultrasound does not reveal prostate cancer on the screen. It can guide the doctor was to take a tissue sample but biopsies can miss aggressive prostate cancer and instead only be choosing samples of cancer much less aggressive, slow-growing, and that do not require treatment.

What is mpMRI?

That’s where multiparametric magnetic resonance imaging (mpMRI) offers men with an elevated PSA another alternative with high-quality imaging taking the guess work out by clearly visualizing cancer within the prostate.  Better yet, mpMRI helps identity accurately tumors that need treatment from indolent tumors that do not.

When a man is suspected of possibly having prostate cancer, the main priority is to accurately assess the presence of clinically significant tumors.  From there, an accurate assessment of the extent of disease at diagnosis and risk of future progression, are other important factors in helping avoid unnecessary overtreatment or undertreatment, especially for men opting for active surveillance.

In addition, mpMRI offers reliable visualization of potentially significant prostate cancers and provides information for staging the tumor and for monitoring treatment response.

Here are 4 reasons to choose mpMRI

1. It may help men avoid an unnecessary biopsy – A prostate biopsy uses a thin needle inserted into the wall of the rectum and on into the prostate gland to collect a sample of tissue. This may be repeated up to 12 times to take 12 separate samples. If tissue samples do not have cancer, a follow-up biopsy may be necessary.
2. It’s non-invasive and pain-free – During a biopsy, usually, a local anesthetic is applied to numb the area but men may notice blood in their urine or semen for up to several weeks after the biopsy. An MRI uses magnetic waves to image inside the body and is totally painless and non-invasive.
3. It can tell how advanced prostate cancer is and whether it has spread – An MRI machine is essentially a large, powerful magnet. The machines use magnetic and radio waves to produce detailed images of soft tissues and structures in the body, like the prostate. MRIs are also better than a prostate biopsy for differentiating between clinically significant and insignificant cancers.

4. It can detect other prostate conditions – Besides being able to detect prostate cancer, a prostate MRI can also detect other prostate conditions such as infections or benign prostatic hyperplasia (BPH).

An MRI is very safe and no radiation is involved. The benefits of having the test outweigh any possible risks which may include:

• Bruising and swelling around the area where a needle is placed for the cannula.
• Allergic reaction to the contrast medium injection, which is very rare.

Any man who is recommended to have a mpMRI or wants to learn more about this test for detecting prostate cancer, should discuss this with his urologist to have a full understanding of this procedure and how it will benefit a more accurate and reliable diagnosis of prostate cancer.

Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board-certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy.  Dr. Samadi is a medical contributor to NewsMax TV and is also the author of The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911.