Prostate MRI is a Non-Invasive Procedure

Prostate MRI is a non-invasive imaging technique that does not require entering the body or breaking the skin. 1

What is a Prostate MRI?

Prostate Magnetic Resonance Imaging (MRI) is a radiation-free imaging modality that provides:

High-resolution anatomic evaluation of the prostate gland and seminal tract 1
Excellent soft tissue contrast for detailed visualization of prostate structures 1
Multiplanar (multiple viewing angles) imaging capabilities 1
Both anatomical and functional information about the prostate 2

Prostate MRI is performed in the following manner:

The patient lies on an examination table that slides into the MRI machine 1
Images are typically acquired using either a 1.5 Tesla or 3 Tesla MRI scanner 1
A surface phased array coil is placed over the pelvis 1
An endorectal coil (inserted into the rectum) is sometimes used but is neither mandatory nor preferred according to current guidelines 1
Multiple imaging sequences are obtained, including T1-weighted, T2-weighted, diffusion-weighted, and often dynamic contrast-enhanced images 1

Prostate MRI is classified as non-invasive because:

It does not require insertion of instruments into the body (when performed without an endorectal coil) 1
No radiation is used, unlike CT scans 1
It is operator-independent, meaning the quality of images doesn't depend on the person performing the scan 1
It can be performed when other imaging modalities like transrectal ultrasound (TRUS) are unsatisfactory 1

In contrast to non-invasive prostate MRI, truly invasive prostate procedures include:

Transrectal ultrasound (TRUS)-guided biopsy, which involves inserting a needle through the rectum into the prostate 1
Pelvic angiography, which requires catheter insertion into blood vessels 1
Transurethral procedures that involve instruments passed through the urethra 1

Prostate MRI is used in various clinical scenarios:

Detection and localization of prostate cancer 3, 4
Staging of known prostate cancer 3
Guiding targeted biopsies 3, 4
Treatment planning for radiation therapy or focal therapy 5
Follow-up after treatment to assess for recurrence 1
Evaluation of the prostate gland and seminal tract in men with hematospermia (blood in semen) 1

While prostate MRI is non-invasive, there are some important considerations:

If contrast is used (for dynamic contrast-enhanced sequences), an intravenous injection is required, which is minimally invasive 1
Some patients may experience claustrophobia in the MRI scanner 3
Patients with certain metallic implants or devices may not be eligible for MRI 3
The procedure is generally safe but requires patients to remain still for 30-45 minutes 6

Recent technological developments have further improved prostate MRI:

Multiparametric MRI (mpMRI) combines anatomical and functional sequences for better diagnostic accuracy 6, 4
Higher field strength (3T) scanners provide improved signal-to-noise ratio and spatial resolution 1
Advanced post-processing techniques and artificial intelligence applications are enhancing image interpretation 6
Newer techniques like MR fingerprinting, luminal water imaging, and restriction spectrum imaging are being developed 6