Multiparametric MRI (mpMRI) scan for prostate cancer

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MRI stands for magnetic resonance imaging. It is a type of scan that creates pictures using magnetism and radio waves. MRI scans produce pictures from angles all around the body and shows up soft tissues very clearly. 

The multiparametric MRI (mpMRI) is a special type of MRI scan that produces a more detailed picture of your prostate gland than a standard MRI scan does. You usually have an mpMRI scan if doctors suspect that you have prostate cancer.

Why you might have an mpMRI

It is important to know that an mpMRI scan alone cannot diagnose prostate cancer. But it can help your doctor to see:

  • whether you have an area in the prostate gland that looks suspicious
  • if you need a biopsy 
  • where to take the biopsies from your prostate
  • if the suspected cancer is just within the prostate or has spread outside it

Preparing for your mpMRI scan

Before you go to your appointment, or when you arrive, you fill in a safety checklist. This asks about:

  • any operations you’ve had
  • whether you have any metal implants or other metals in your body

An MRI scan uses strong magnetism which could affect any metal in your body. This includes:

  • pacemakers or an implantable defibrillator (to treat abnormal heart rhythms)
  • surgical clips, pins or plates
  • cochlear implants (for deafness)
  • metal fragments anywhere in your body – for example from an injury, dental fillings and bridges

You can still have an MRI scan if you have some metals in your body, but your doctor and radiographer decide if it’s safe for you. Tell the scanner staff about any metals in your body.

Some people feel claustrophobic or closed in when they’re having an MRI scan. Contact the department before your test if you’re likely to feel like this. The hospital staff can take extra care to make sure you’re comfortable and that you understand what’s going on. Your doctor can give you medicine to help you relax if you need to.

The radiographers let you know whether you need to empty your bowels of any poo or gas before having the scan. In some departments, you might be given an enema. An enema is a liquid filled pouch that has a nozzle that you can put into your back passage and it helps to empty your bowels. 

What to expect

Having an mpMRI scan feels the same as having an MRI scan. You won’t notice anything different if you have had an MRI in the past.

When you arrive at the scanning department, the radiographer might ask you to change into a hospital gown. You might not have to undress if your clothing doesn’t have any metal, such as zips or clips. 

You have to:

  • remove any jewellery, including body piercings and your watch
  • remove your hair clips
  • empty your pockets of coins and keys

It’s safe to take a relative or friend into the scanning room with you. But check with the department staff first. Your friend or relative will also need to remove any metal they have on them.

In the scanning room

Your radiographer takes you into the scanning room. The MRI machine is large and shaped like a doughnut.

You lie on your back on a couch that can slide into the MRI machine. 

You may have an injection of a dye (contrast medium) through a small plastic tube (cannula) into a vein in your arm. This helps to show up your prostate more clearly. Some people are allergic to the dye, so your radiographer will check first about any medical conditions or allergies you have.

After the dye injection you may:

  • feel sick
  • have a headache
  • feel warm or flushed
  • have a metallic taste in your mouth
  • feel a little dizzy

These effects are usually mild and last for a short time. Tell your radiographer if you feel unwell at any point during or after your scan.

Having the mpMRI scan

You need to lie as still as possible. The scan is painless but it can be uncomfortable to stay still. Tell the radiographer if you’re getting stiff and need to move. 

The scan usually takes up to 10 minutes.

Once you’re in the right position on the couch, your radiographer leaves the room. They can see you on a TV screen or through a window at all times from the control room. You can talk to each other during the scan, usually through an intercom.

The couch moves through the MRI scanner. It takes pictures as you move through it. Your radiographer might ask you to hold your breath at times. 

The scanner makes a very loud clanging sound throughout the scan. You wear headphones to protect your hearing. You can also listen to music. Keeping your eyes closed can help.

After your scan

When the scan is over, your radiographer comes back into the room and lowers the couch so that you can get up.

You usually stay in the department for about 15 minutes. This is in case the dye makes you feel unwell.  

Your radiographer removes the cannula from the vein in your arm before you leave.

You should then be able to go home or back to work, and also eat and drink normally.

Possible risks

An MRI is very safe and doesn’t use radiation. Some people can’t have an MRI but the checklist picks this up beforehand. Your doctor and radiographer make sure the benefits of having the test outweigh any possible risks.

Some of the possible risks include: 

Bruising and swelling

You might get a small bruise around the area where they put the needle in for the cannula. 

There’s a risk that the contrast medium will leak outside the vein. This can cause swelling and pain in your arm but it’s rare. Tell your radiographer if you have any swelling or pain. Let your GP know if it doesn’t get better or starts to get worse when you’re at home.

Allergic reaction 

An allergic reaction to the contrast medium injection is rare. This most often starts with feeling weak, sweating and difficulty breathing. Tell your radiographer straight away if you feel unwell so they can give you medicine to control the reaction.

Getting your results

You should get your results within 1 or 2 weeks. 

Waiting for results can make you anxious. Ask your doctor or nurse how long it will take to get them. Contact the doctor who arranged the test if you haven’t heard anything after a couple of weeks.

You might have contact details for a specialist nurse who you can contact for information if you need to. It may help to talk to a close friend or relative about how you feel.

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Dr. Ahmed Hafez
CEO & Founder of MEDICINE21 corporation