Much attention paid to multiparametric prostate MRI (mp-MRI) has focused on its ability to improve prostate cancer detection and diagnosis. However, prostate MRI has the potential to improve other aspects of prostate cancer care. Beyond guiding biopsy needles, prostate MRI can also aid prostate cancer staging, inform treatment planning and to monitor patients following treatment.
At the Capitol Imaging Services affiliate, Diagnostic Imaging Services (DIS), our prostate mp-MRI studies are conducted on our 3T ultra high field MRI ,the type of system that should be used for prostate studies. Anything less than 3T will not arrive at the type of quality images and data needed by the radiologist to make a thorough report for the urologist. In addition to 3T technology, DIS utilizes Computer Aided Detection (CAD) which assists in further pinpointing areas of concern that could be cancer.
Pre-treatment staging is most often essential to determining an appropriate disease management strategy in men with prostate cancer. Staging prostate cancer often currently relies on digital rectal exam, prostate-specific antigen levels and Gleason score. Collectively, these indicators can predict the risk of extra-capsular extension (ECE), but they do not provide information regarding localization or extent.
For potential surgical candidates, differentiating between cancers confined to the prostate and those that have spread beyond the prostate is especially important. Compared with alternative imaging options, prostate MRI offers the most accurate assessment of local prostate cancer and regional metastatic spread.
Prostate MRI can effectively evaluate for ECE, including involvement of the neurovascular bundle and invasion of adjacent structures like the seminal vesicles, bladder and rectum. Knowledge of lymph node metastases is also essential to appropriate treatment planning and prostate MRI can also be used to help detect lymph node metastases.
Treatment Planning, Response to Treatment and Active Surveillance
Following a prostate cancer diagnosis, prostate MRI can confirm whether disease is caused by an early-stage tumor and help to stratify patients into active surveillance or radical treatment. If intermediate- or high-risk cancer is confirmed, prostate MRI can guide both surgical and non-surgical treatments.
Prostate MRI is particularly useful in surgical patients due to its ability to investigate for ECE and seminal vesicle involvement. It has significantly improved decisions to preserve or remove the neurovascular bundle, according to one review of relevant clinical literature published December 2013 in the American Journal of Roentgenology.
Prostate cancer treatments should not be the same for every man dealing with this disease. For men with a prostate cancer diagnosis, prostate MRI can reveal information about their disease to help them more confidently make treatment decisions. It’s strongly recommended that men who have been diagnosed by trans-rectal ultrasound (TRUS) biopsy also receive prostate MRI to receive more information about their cancer and their options.
And at DIS, that recommendation results in ultra high field MRI quality and CAD analysis. The radiological academic approach to each prostate 3T study is what truly sets Diagnostic Imaging Services apart from other providers, hospital or independent.
All 3T MRI exams performed by Diagnostic Imaging Services are at their Marrero, Metairie – Veterans Memorial Boulevard and Slidell, LA locations.
Capitol Imaging Services is doctor trusted and patient preferred.