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.
In the past, men at elevated risk for prostate cancer received a prostate biopsy. However, the biopsy often missed cancer, and in other cases, led to the over-treatment of less-threatening cancers. With prostate MRI, doctors now have a tool that can view the entire prostate gland, distinguish between cancer and healthy tissue, and determine if another prostate condition (like prostatitis—an inflammation of the gland) is the cause of elevated PSA. If a biopsy is needed, MRI can help to ensure both the sampling, and the diagnosis, is accurate. For men without prostate cancer, MRI can help them avoid an unnecessary biopsy.
The American Urological Association now recommends prostate MRI as a front-line test to assess or rule out prostate cancer—before a biopsy is performed.
In the past, the standard approach for prostate cancer detection was to conduct PSA screening, and when the screening showed elevated PSA levels, a transrectal ultrasonography (TRUS)-guided biopsy was recommended. Unfortunately, this approach has been shown to have low sensitivity and provides limited information about the true extent and aggressiveness of the cancer.1
During a biopsy, only about 1% of the prostate gland is sampled. This means that tumors can be easily missed, especially near the top of the gland where obtaining a biopsy is more challenging.
Studies show that biopsies miss about 20% of all malignancies and generally underestimate the disease2. Because of this, prostate cancer continues to be a leading cause of death in men, equivalent in death rate and financial impact to breast cancer in women.
Traditionally, men are screened for prostate cancer with a blood serum test called Prostate-Specific Antigen (PSA), and a Digital Rectal Exam (DRE). If either screening shows an abnormality, you may be at risk for prostate cancer.
Imaging Healthcare Specialists (IHS) is the only radiology provider in greater San Diego to use restriction spectrum imaging (RSI). An FDA-cleared post-processing software, RSI supports improved detection of clinically significant prostate cancer. It has allowed IHS radiologists to distinguish between slow-growing (non-threatening) and more aggressive cancers, an essential factor that can influence the decision to either intervene or conduct active surveillance.
Supported by artificial intelligence and the skill/experience of the radiologist, this technology enables a faster and more accurate PI-RADS scoring. Our radiologists are among the most experienced in the nation at performing this test, have extensive experience working with regional urologists, and remain at the forefront of their field. Our reputation is such that patients from all over California travel to IHS for prostate MRI testing.
Through our partnership with CorTechs.ai prostate MRI at IHS 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.
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.
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.
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 IHS, 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.
1. 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 (IHS).
2. 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).
3. You will be contacted by an 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 give preparation instructions, along with a time to arrive at the center. As part of your preparation, you will be asked not to eat any food 6 hours prior to your appointment time, and to drink plenty of water to stay well hydrated the day of the exam.
4. 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.
5. 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.
6. 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.
7. 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.
Supporting Clinical Evidence