A better way to detect and assess prostate cancer

The American Urological Association now recommends prostate MRI for patients at elevated risk before undergoing a biopsy.

A new tool has emerged to provide better detection and assessment of suspected prostate cancer. Known as prostate MRI (or multiparametric MRI), this test can help you and your doctor better understand your risk as well as help contribute to a more targeted and effective treatment of the disease.

OnQ Prostate

Through our partnership with CorTechs.ai prostate MRI at Imaging Healthcare Specialists (IHS) of Southern California uses a unique diffusion technique called OnQ Prostate along with artificial intelligence. OnQ Prostate is a post-processing software for multiparametric prostate MRI (mpMRI) images. It leverages an advanced diffusion MRI technique and utilizes artificial intelligence to enable greater accuracy in differentiating prostate cancer from normal prostate tissue. This provides valuable information that helps our doctors to differentiate between clinically significant, aggressive cancer and less threatening, slower-growing cancer. We are the only regional imaging center network to offer this advanced technology on all prostate MRI exams.

Improved Detection

This technology improves prostate cancer detection over mpMRI alone, giving you and your doctor an added measure of confidence in your prostate diagnosis. In fact, when mpMRI is combined with OnQ Prostate, it achieves 85% accuracy versus 79% accuracy with mpMRI alone.

OnQ Prostate: Case Study

OnQ Prostate Case Study

To understand why OnQ Prostate with RSI technology can make a real difference when it comes to your prostate MRI exam, please read the resources below. You can also download and share these PDFs with others, including your doctor.

The advantages of prostate MRI

MRI allows doctors to better visualize the entire prostate gland. This can help to rule out the need for a biopsy, or if one is needed, it can ensure that biopsies are taken from the most suspicious areas—and not just randomly.

At Imaging Healthcare Specialists, our advanced MRI systems provide exceptionally detailed images of soft tissue within the body, such as those of the prostate gland. Combined with our expertise in interpreting prostate MRI exams, this test can help detect or rule out suspected cancer, determine cancer stage, conclude whether the cancer is contained, and help you and your doctor determine an appropriate course of treatment. We can also detect other, non-cancerous diseases of the prostate, such as prostatitis (infection) or BPH (enlargement).

Prostate MRI is safe, accurate and painless, and has been shown to identify cancer in more than 50% of men whose initial biopsy was negative. 

What should I expect?

The following are the steps you and/or your doctor will take before, during and after your prostate MRI examination.

prostate mri - suspicion

1. Suspicion

Your doctor suspects a prostate issue

You may have an elevated or rising PSA. You may have had an abnormal rectal examination. Or, your doctor may be looking at a combination of factors such as your family history, ethnicity, weight, age or other risk factors. 

At this point, your doctor may recommend that you have a prostate MRI examination at Imaging Healthcare Specialists.

prostate mri - referral

2. Referral

You receive a referral to IHS

If you and your doctor agree that a prostate MRI test is right for you, you will receive a referral from your doctor that is sent to our scheduling department. This means that your doctor has recommended this test to help determine if the prostate “issue” is caused by cancer, or if it is the result of a benign condition, such as an enlarged prostate (also called BPH) or prostatitis (inflammation).

prostate mri - contact

3. Contact

You will be contacted by IHS Patient Concierge

When IHS receives the referral, our Patient Concierge will reach out to you by phone within 24-48 hours to schedule your prostate MRI examination. They will schedule your exam at a time that works for your schedule, inform you about how long the exam will take, and provide directions to which location your test will take place. Prior to your arrival, you will be given preparation instructions, along with a time to arrive at the center. As part of your preparation, you will be asked to purchase a bottle of magnesium citrate at your local pharmacy, which you will drink at 4 pm the day before your test. You will be asked to eat no food 6 hours prior to your appointment time, but you may drink plenty of water or Gatorade. 

prostate mri - day of test

4. Day of Test

On the day of your appointment

If you choose contact-free check in, you will be contacted 2-3 hours prior to your test to fill out any forms that may be needed online. If you choose this option, you will bypass the waiting room and will be taken directly to the MRI suite. The test itself takes less than an hour. The technologist will inform you what to expect, and be in audio contact while you are inside the MRI machine. If you have any questions, the IHS radiologist will be on hand to answer them. The radiologist is a medical doctor specialized in diagnostic imaging who will consult with you and your doctor about your test results.

prostate mri - results

5. Results

Test results

Your doctor will receive a detailed report with your prostate MRI findings. In some cases, the test will reveal no prostate cancer, and possibly identify another condition causing your prostate issue. Your doctor may recommend medication or lifestyle changes, and monitor biomarkers to help ensure that your PSA levels or risk factors are reduced. In some cases, it will reveal the presence of cancer. The radiologist may be able to assess the nature of the cancer and work with your doctor to determine if a prostate biopsy is needed. 

prostate mri - discussion

6. Discussion

Discussion with your doctor

After your prostate MRI, you will likely be called in for a consultation with your doctor. If a small cancer was found, you may be advised to take no action today but monitor the disease over time. If a more aggressive form of cancer is suspected, a biopsy will be recommended. 

prostate mri - follow-up

7. Follow-up

Follow-up testing

For men with slow-growing cancers, a strategy of “active surveillance” is often recommended. This means that your doctor does not think cancer treatment is needed at this time, but that your prostate gland should be monitored. You will likely have another prostate MRI at a prescribed interval—6, 12 or 24 months after your first MRI. By monitoring the progression, your doctor can assess changes in your prostate gland to help determine if treatment for prostate cancer is required. 

If a biopsy is needed…

The images provided with your prostate MRI test results will help to make sure that your biopsy sample is taken from the most suspicious area(s) within the gland. Your biopsy will use imaging (ultrasound or MRI) to guide a very thin needle into the prostate gland, where samples will be removed and then sent to a laboratory for further evaluation. The results of the biopsy can help determine the best course of treatment for your individual condition. 

Ultrasound-guided biopsies are typically performed at your urologist’s office. If MR-guided biopsy is recommended, this will be performed at IHS’ Encinitas location.

In preparation for a prostate biopsy, an IHS nurse will contact you to arrange that you take an antibiotic one day before, the day of, and one day after your biopsy. You will undergo two fleet enemas an hour apart the morning of the procedure. You should have no food after midnight the evening before your biopsy, although you are able to drink water and take medication as prescribed. Conscious sedation is used to reduce discomfort associated with biopsy (the same type used for a colonoscopy). As a result, you will need someone to drive you to and from your biopsy appointment.

Is prostate MRI right for me?

Prostate MRI is recommended if you have:
  • Elevated PSA and another risk factor for prostate cancer 
  • Experienced repeated, negative biopsies 
  • Already been diagnosed with prostate cancer, in particular small-volume, higher Gleason grade disease

If you are at risk for prostate cancer, prostate MRI may provide the “missing piece” of information needed to catch aggressive cancers early and avoid unnecessary treatment of cancers that pose little to no risk to your health.

Supporting Clinical Evidence

    1. Ahmed HU, Kirkham A, Arya M, et al. Is it time to consider a role for MRI before prostate biopsy? Nat Rev Clin Oncol 2009; 6:197–206
    2. C J Harvey, MRCP, FRCR,1 J Pilcher, MRCP, FRCR,2 J Richenberg, MRCP, FRCR,3 U Patel, MRCP, FRCR,2 and F Frauscher, MD4 Applications of transrectal ultrasound in prostate cancer Br J Radiol. 2012 Nov; 85(Spec Iss 1): S3–S17.
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