Mri Scanner

[Bazile]

Further to a previous question on prostate

How effective is an MRI scan in showing whether or not a biopsy is required ?

[mushroom25]

i'm advised (by an MRI PCA) that it's standard NHS practice to do the MRI before any biopsy - because poking the prostate can cause blood movement that could distort the results - but current scanning imagery means the scan will result in a conclusive "yes" or "no" for biopsy.

[Sqad]

It is absolutely essential to local the tumour area in the peostate as a guide to the accuracy of the biopsy.
In the US and Europe, one would not have a biopsy without an MRI scan, but unfortunately in the UK there are not enough scanners to accommodate all the patients.
Researchers were looking at an advanced type of MRI scan, known as a multi-parametric MRI, which as well as looking at the shape and size of the prostate, can also assess other factors such as blood flow through the gland.

I would not have my prostate problems assessed or treatment started without an MRI scan.

[Sqad]

After reading my post I realise that I haven't answered your question.

Many surgeons are sceptical if one can diagnose a malignant lump in the prostate by MRI alone .
It depends upon the skill of the Radiologist and the type of scanner used. Up until a decade ago it was thought that about 30% of malignant prostate tumours could be picked up, but now, Radiologists are talking about 90%.
My other comments in my first post remain the same.

[Bazile]

So , is it the case then that the only way to be certain if a prostrate had cancer , is to do a biopsy ?

[Bazile]

That should be - ' has ' - cancer

[Sqad]

Yes.......providing that the biopsy is taken from the right part of the prostate gland, which isn't always the case. BUT after having an MRI scan, the biopsy needle can be directed to the exact place of the "tumour" providing an accurate biopsy.

[Bazile]

At the risk of sounding silly .

In the first place how do they determine if there is a tumor ?

[Sqad]

On the symptoms of prostatic disease e.g difficulty in passing water and a poor stream etc, possibly a high PSA ( blood test)and on rectal examination, a hard enlarged prostate gland is felt.

All or any of the above may indicate prostate disease and may require a biopsy.

[Bazile]

Thank you

[Bazile]

You say-'may indicate '
as opposed to - 'indicate' ?

[Sqad]

Never say never in Medicine.

[Bazile]

You say 'the biopsy needle can be directed to the exact place of the 'tumor '

Does that mean that a MRI scan shows that a 'tumour ' is at a particular location in the prostate ?

[Sqad]

Exactly.......so that you can guide your biopsy needle to the EXACT centre of the tumour.

[Bazile]

Ah right.

So an MRI scan will show if there is a tumour .

Then a biopsy will tell you if that tumour is malignant .
Is that correct ?

[Sqad]

Correct.

[Bazile]

Thanks sqad

[Bazile]

Thank you also mushroom25 for responding

[tinkerbell23]

Im late to the thread as usual.

Where i work we dont do MRIs first (subjective!!)

Some men demand an MRI first (I likely would)

Even after MRI theres a risk of a “false negative” - If PSA is still raised, evidence on MRI of tumour we then send for template/targeted biopsy.

Prostate cancer uk.org has some really helpfull info.

Im not on as much these days but if I may help Im sure someone would give me a shout!

Im sure I have told you before I am a Urology CNS and give these biopsy results week in week out xx