Visualization of the prostate with a low dose of X-rays is a multi-parametric or functional magnetic resonance imaging of the prostate and is a modern, very accurate diagnostic method using strong magnetic fields. In patients with elevated PSA, MRI of the prostate gland is advisable, if patients have already prostate biopsy taken (sampling) and no tumors were found in the materials. In addition, if the presence of a tumor has been confirmed during the biopsy material analysis, its stage (tumor classification) can be determined, which, if appropriate, will be of great importance when choosing a method of treatment.

Multiparametric MRI (mpMRI) of the prostate gland combines a standard anatomy sequence with a high resolution and two functional sequences. They include T1- and T2-weighted high-resolution sequences that allow anatomical image of the prostate and pelvic structures, diffusion-weighted images (DWI) for visualization of cell density, and dynamic T1 sequences with contrast enhancement for visualization of perfusion in the form of functional sequences. Due to this combination of sequences (T2, DWI and DKU), it is possible to conduct a good, qualitative and reliable diagnosis of the prostate gland.

Indication for examination:

Check for the presence of a tumor (oncosis):

  • elevated, exceeding the norm or increasing parameters of PSA and/or a family history with no pre-biopsy (primary indication).
  • After a biopsy under the control of a transrectal ultrasound (TRUS) with negative results, in constantly increased, exceeding the limits of norms or increasing parameters (secondary indication).

Tumor spread (definition of the stage of disease):

  • prostate carcinoma, which has already been confirmed during a biopsy, or accidentally detected prostatic carcinoma to determine the prevalence of the tumor, if necessary to identify foci of a more advanced stage/more aggressive or additional foci of the tumor (the time to biopsy should be as far as possible ≥ 6 weeks).

Follow-up with a known low-risk carcinoma:

  • A known low grade prostate carcinoma (Gleason score of 6 or 7a) before biopsy, if necessary before repeated biopsy (active monitoring).

Suspicion of recurrent carcinoma of the prostate:

  • Increased PSA parameters after treatment (after radical removal of the prostate gland, radiation therapy, local irradiation / implantation of radioactive grains, etc.).

Additional indications:    

  • Fuzzy clinical data (e.g., hematospermia of unknown origin, unclear results of ultrasound, etc.).

The natural motility of the intestines can prevent obtaining MR-scans of proper quality due to the appearance of motional artifacts on them. Therefore, every patient must take the drug (Buscopan® or Glucagon®) before examination, if there is no contraindication to this. Contraindication to taking Buscopan® is an increased intraocular pressure (glaucoma) or heart rhythm disturbances. After examination, outpatients should refrain from active participation in traffic. With existing diabetes, Glucagon® should be discontinued. For the examination of the prostate, a standard contrast medium for MRI is administered to the patient during examination. This contrast substance is basically very well tolerated and only in rare single cases leads to allergic reactions.

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