MRI is ideally suited to generate high resolution image data of the lesser pelvis. By means of our sophisticated MRI scanners with field strengths of 1.5 and 3.0 tesla (Siemens Magnetom Aera, Verio, and Skyra), we can provide prostate examinations without the need to introduce a measuring coil (endo-rectal coil) into the rectum, while still applying current techniques as required by the Society for Urology and Uroradiology as part of the so-called "multiparametric MRI" (mpMRI). In this examination, the detection of prostate cancer is based on the use of high resolution morphological measuring sequences with slice thicknesses of up to 1mm as well as on diffusion and perfusion measurements. The latter two methods are used to depict the cell density and vascular supply — both parameters that are abnormal in case of a malignant tumor.
A prostate MRI is an elaborate examination, and with its measuring time of 30 minutes and more places higher demands on both staff and equipment. Reproducible and reliable results can only be obtained in the hands of experienced and competent specialists. With Adjunct Prof. Dr. Anno Graser we have a specialist for uroradiology widely recognized throughout Germany in our team who has been performing these examination procedures since his doctoral thesis on prostate MRIs, i. e., for more than 15 years, and who works very closely with numerous urology colleagues. Together with the medical colleagues at Radiologie München he is part of the team that will evaluate the examination.
When is a prostate MRI appropriate and what does such an examination cost?
If you have had a raised PSA level or your urologist detected some abnormalities by means of prostate palpation, it may be appropriate to perform a MRI examination of the prostate to look for potentially tumorous areas before taking a punch biopsy. Due to its very high local resolution, MRI imaging can be used to guide a biopsy by means of transrectal ultrasound (TRUS) in the course of a so-called fusion biopsy procedure in case of potentially tumorous findings.
A prostate MRI may also be appropriate for early prostate cancer detection, since it facilitates an image of the entire gland and thus the advantage of a full coverage of the organ compared to just a primarily localized biopsy. However, an MRI is not a tissue-specific examination, which means that if a tumor is suspected a biopsy would always follow.
The costs of the examination are covered by private insurance carriers only. The statutory health insurance does not provide for prostate MRIs, which means that patients will have to cover those costs.
What can a prostate MRI reveal, and what are its limits?
For diagnostic accuracy of a prostate exam two factors are of critical importance: The use of advanced technical equipment and an evaluation by a very experienced radiologist in consideration of the so-called PI-RADS criteria (“Prostate Imaging Reporting and Data System”) in their current version V2. Radiologie München offers both at our locations at Burgstraße and Alter Hof (Dienerstraße) as well as in Säbener Straße on the FC Bayern training grounds.
The benefit of this examination lies in the confirmation or exclusion of clinically relevant tumor diseases of the prostate. It is particularly beneficial in detecting harmful prostate carcinomas, since these are often difficult to distinguish, as well as those that are larger than 1cm or already expand past the prostate. However, this method is not able to reliable detect small tumor cell clusters or very clearly differentiated and thus very slowly growing tumors, although those are of little or no clinical relevance.
For you as a patient that means: In the hands of a specialist and with a realistic and exact assessment, this examination is a powerful means for a reliable detection of harmful prostate cancer. Furthermore, in accordance with the latest scientific findings, this method provides for a clear distinction between an inflammation and prostate cancer.
Do you have questions, or are you interested in a consultation? Please contact Adjunct Prof. Dr. Graser by email (firstname.lastname@example.org). He will gladly assist you and answer your questions!