The Prostate MRI Procedure at ARA: What to Expect
Prostate cancer is one of the most common types among men, but not all prostate cancers are alike. Some are slow-growing and may need monitoring, while others are aggressive and can spread quickly to other parts of the body. How can you tell the difference? One way is to get a prostate MRI at ARA Diagnostic Imaging.
Your healthcare provider may recommend a prostate MRI examination if you have been diagnosed with prostate cancer or have symptoms that suggest it, such as an increased level of PSA (prostate-specific antigen) in your blood. A prostate MRI can help your healthcare provider determine the extent and aggressiveness of your cancer, plan your treatment options, and monitor your response to therapy.
To schedule an MRI at ARA, please call (512) 453-6100 and follow the directions to reach a specially trained scheduler who can talk to you about your health history and make an appointment at one of the many ARA imaging centers that offer MRI.
But what does a prostate MRI entail, and how does it work? We will explain the benefits, risks, preparation, and process of having a prostate MRI procedure.
What is a prostate MRI?
A prostate MRI is a noninvasive imaging test that uses a powerful magnetic field, radiofrequency pulses, and a computer to create detailed pictures of your prostate gland and surrounding tissues. It is generally safe and painless and does not use radiation.
A prostate MRI can help ARA radiologists diagnose and evaluate various conditions affecting the prostate, such as prostate cancer, infection, abscess, enlargement, complications after pelvic surgery, or congenital abnormalities. You may have a prostate MRI before or after a biopsy depending on your situation.
The MRI can provide valuable information about your prostate health and help you and your healthcare provider make informed decisions about your treatment options.
How does a prostate MRI work?
A prostate MRI usually takes about 20 to 40 minutes to complete. You will lie on a table that slides into a large tube-shaped machine that contains a strong magnet. You will need to stay still during the scan and follow some simple instructions from the technician. You may also need to hold your breath for short periods.
Before the exam, you will be asked to change into a gown and remove all jewelry and metal from your body. For more information, see Can I have an MRI if I have metal in my body?
You may need an injection of contrast dye into a vein in your arm or hand before or during the scan. The contrast dye helps highlight specific areas of your prostate and makes them more visible in the images.
The MRI machine will make loud noises as it takes pictures of your prostate. You can ask your MRI technologist for earplugs or listen to music through headphones to make you more comfortable, blocking out some of the noise. During the scan, you can also talk to your technologist through an intercom system.
The Benefits of a Prostate MRI
One of the primary uses of a prostate MRI is to assess the extent and aggressiveness of prostate cancer and determine whether it has spread beyond the prostate gland. An MRI can help healthcare providers plan the best treatment options for your specific condition.
Getting a prostate MRI has many benefits, especially if you have been diagnosed with or suspected of having prostate cancer. Some of these benefits include:
- Accurate diagnosis: A prostate MRI can help detect small tumors that other tests, such as blood tests or ultrasound, may miss. A prostate MRI can also help determine if you have benign conditions that can cause symptoms similar to prostate cancer, such as infection or inflammation.
- Precise biopsy: If you need a biopsy to confirm your diagnosis, a prostate MRI can help guide your healthcare provider on where to take tissue samples.
- Finds cancer that has metastasized: A prostate MRI can detect metastasized cancer that has spread to areas other than the prostate.
- Cancer staging and treatment planning: Because a prostate MRI can show the extent and location of cancer, it can help you and your healthcare provider decide what treatment you need, such as surgery, radiation therapy, hormone therapy, or active surveillance (watchful waiting). Over time, MRI can also help determine if you need to switch treatments.
- Improved monitoring: If you choose active surveillance as your treatment option, follow-up prostate MRIs can help monitor any changes in your tumor size or activity over time. Regular monitoring can help you and your healthcare provider decide if you need to start treatment.
What are some limitations or risks of getting a prostate MRI?
A prostate MRI is generally very safe and effective for most people. However, there are some limitations or risks that you should be aware of before undergoing the procedure:
- Let your ARA scheduler know if you have metal in your body: Since MRI uses a strong magnet, metal on or inside the body may be affected. Your ARA MRI scheduler can talk to you about how to have a safe MRI. Be sure and inform them about pacemakers, cochlear implants, artificial limbs or joints, and metal implants or pieces in your body such as stents, infusion ports, metal screws, plates, and surgical staples or other items.
- MRI may not be appropriate for people with some medical conditions: MRI is not recommended for people with severe kidney disease.
- You may need a contrast agent: A prostate MRI generally requires an injection of a contrast agent called gadolinium, which helps enhance the visibility of abnormal tissues. In rare cases, gadolinium can cause allergic reactions, ranging from mild skin rashes to severe breathing problems. Healthcare providers and radiologists understand these risks and do not recommend MRI unless the benefits far outweigh the risks. To ensure your safety, ARA also has on-site physicians and EMTs experienced in dealing with allergic reactions to contrast.
- You may experience claustrophobia or anxiety: Some people feel anxious about getting an MRI because of the semi-enclosed shape of the MRI interior space or the banging and humming noises produced during the exam. But rest assured that ARA’s MRI technologists are experts at helping you feel comfortable about your exam. The technologist can provide headphones to listen to music or earplugs to block out some noise. You may also ask your healthcare provider for a mild sedative if you are very nervous about having an MRI.
How do I prepare for a prostate MRI?
A prostate MRI is generally safe and painless. However, there are some things you need to do before and during the procedure to ensure its accuracy and safety.
Before the procedure:
- Tell your ARA scheduler about any medical conditions, especially if you have kidney problems or allergies to the contrast agent (gadolinium) used for MRI.
- Tell your ARA scheduler about any metal implants or devices in your body, such as pacemakers, stents, cochlear implants, artificial joints, or metal clips. Some of these may interfere with the magnetic field and cause problems during the procedure. For more information, see Can I have an MRI if I have metal in my body?
- Unless otherwise instructed, you can eat and drink normally and take all your normal medications before your MRI exam.
- Leave any jewelry or metal objects at home or remove them before entering the MRI room.
During the procedure:
- You will lie on a narrow table that slides into a large cylindrical machine that contains a magnet. Your technologist can provide you with headphones to listen to music or earplugs to block out noise from the machine.
- Your MRI technologist will place a surface coil over your lower abdomen and pelvis area. A coil is a device that helps create clearer images by sending and receiving radio signals.
- You will be asked to stay still and occasionally hold your breath for short periods during the scan. The scan may take 20 to 40 minutes, depending on the number of images needed. You will be able to talk with your MRI technologist at all times during the exam.
- Some MRIs require injecting a contrast agent into a vein in your arm or hand. The contrast agent helps highlight specific tissues or blood vessels in the images. The contrast agent may cause a warm sensation in your body or leave a metallic taste in your mouth but should not cause any serious side effects.
After the procedure:
- You can resume normal activities immediately unless your healthcare provider instructs otherwise.
- If you were given a contrast agent, drink plenty of fluids to flush it out of your body.
- Your healthcare provider will review the ARA radiologist’s interpretation of images from your scan and contact you regarding the results.
Understanding Your Results
A radiologist, a healthcare provider specializing in interpreting medical images, writes an MRI report. The report is for your referring healthcare provider, who will share the results with you and make decisions about your treatment. Here are some common sections and elements that you may find in your report:
- Type of exam: This section lists the date, time, and type of exam performed. Different types of prostate MRI exams exist, depending on the purpose and technique used.
- Clinical history: This section lists pertinent information about your age, gender, health status, symptoms, the reason for the exam, and diagnosis or suspected diagnosis. This information helps the radiologist interpret the images and provide a relevant report.
- Comparison: This section lists any previous exams the radiologist had compared with the current one. This comparison helps assess any changes over time and monitor the response to treatment.
- Technique: This section lists the technical details of how the MRI technologist did the exam. It includes information about the types of images acquired, the parameters used for each image type, and any special techniques used to measure water molecule motion (water diffusion) or blood flow (perfusion) within the prostate.
- Findings: This section lists the main observations made by the radiologist based on the images. It may include:
- The size and shape of your prostate gland.
- The calculated volume of your prostate gland.
- Any abnormalities in your prostate gland, such as lesions (areas of abnormal tissue), cysts (fluid-filled sacs), calcifications (hard deposits), or atrophy (shrinkage).
- The location of any abnormalities within different zones or regions of your prostate gland.
- The likelihood of any abnormality being clinically significant cancer using a scoring system called PI-RADS. The PI-RADS scores range from 1 to 5. The higher the score, the more suspicious an area is for cancer.
- Very low likelihood
- Low likelihood
- Intermediate likelihood
- High likelihood
- Very high likelihood
- Whether or not cancer has spread beyond your prostate gland into nearby structures such as seminal vesicles (glands that produce semen), lymph nodes (small organs that filter fluid), or bones.
- Any incidental findings outside your prostate gland, such as kidney stones, bladder tumors, or pelvic masses.
Your healthcare provider will discuss your prostate MRI report with you and explain what it means for your situation. Your healthcare provider will also recommend the best next steps based on your individual risk factors and preferences.
Depending on the findings of the prostate MRI, your healthcare provider may recommend the following:
- A prostate biopsy. A prostate biopsy is a procedure to collect tissue samples from the suspicious areas of the prostate and examine them under a microscope for cancer cells. A biopsy can confirm or rule out a diagnosis of prostate cancer and determine how aggressive it is.
- A follow-up MRI. After some time, your healthcare provider may want to order a follow-up MRI to monitor any changes in the size or appearance of the lesions detected by the initial MRI. A follow-up MRI can also assess how well a treatment is working or if there are any complications.
- Other imaging tests. These may include computed tomography (CT), positron emission tomography (PET), bone scan, or lymph node biopsy. These tests can help determine if the cancer has spread to other parts of the body, such as bones, lymph nodes, or organs.
- Treatment options. These may include surgery, radiation therapy, hormone therapy, chemotherapy, immunotherapy, or active surveillance. Treatment choice depends on many factors, such as the stage and grade of the cancer, age, health condition, preferences, and goals.
Getting a prostate MRI exam can have many benefits for your health. It can help you detect prostate cancer early when it is easier to treat, which can give you a better chance of survival. It can also help you avoid unnecessary biopsies or surgeries that may cause complications or side effects. If it is recommended that you go through prostate cancer treatment, MRI will be used to help monitor your response and, after you finish treatment, check for cancer recurrence.