Prostate cancer can take many forms and progress at different rates. In some patients it may appear as a small tumor in the prostate and remain practically stable over time (mild malignancy), without affecting the patient’s life, while in others the cancer progresses rapidly (aggressive form), extends beyond the borders of the prostate or even lymph nodes or other organs (mainly in the bones), giving metastases with a poor prognosis.
Diagnosis of prostate cancer
The diagnosis of cancer is made by corrective biopsy in patients with clinical suspicion (high PSA or positive finger examination) and the form of cancer determines the treatment. With the advancement of technology, in recent years Multiparametric MRI of the Prostate has been established as a very important method for the accurate diagnosis of aggressive (clinically significant) forms of prostate cancer and the proper management of patients.
How is Multiparametric Prostatic Magnetic Resonance Imaging performed?
Prostate Multiparametric MRI is a test performed on modern MRI scans, with the patient in a supine position, lasting about 25-30 minutes and focusing on imaging in the prostate gland. The method combines special functional magnetic resonance techniques with high-resolution anatomical images to highlight clinically significant cancer. Until recently, the diagnosis of prostate cancer was based on systematic corrective biopsy, ie taking biopsies from various sites of the prostate gland and, therefore, an aggressive form of cancer could be lost.
Multiparametric MRI can detect the suspected foci of cancer with great accuracy and determine which or which areas of the prostate should be examined. In this way, samples are taken selectively from the suspicious points revealed by the magnetic resonance imaging (targeted biopsy) and random sampling from the entire prostate gland is avoided, making the whole procedure safer and more efficient.
According to recent guidelines from the European Society of Urology, it is recommended that Multiparametric Prostate MRI be performed prior to any biopsy. In addition, the test has a very high negative prognostic value. This means that if the Multiparametric MRI of the Prostate does not reveal a suspicious focus, we can very accurately reassure the patient and his doctor and avoid a pointless corrective biopsy (if all the clinical laboratory data allow it).
In addition to the initial diagnosis of prostate cancer, Multiparametric Prostate Magnetic Resonance Imaging is extremely useful in accurately assessing the local extent of the cancer (localized staging), in designing the appropriate treatment (surgery or radiotherapy) to achieve better results with reduced complications as well as in the early detection of local recurrence of cancer in patients with elevated PSA after treatment.
Writes:
Fotios Laspas Radiologist
Curator of the Department of Axial and Magnetic Resonance Imaging & Osteoporosis Measurement, HEALTH
.
