The prostate carcinoma is the most common malignant tumor in the male (approximately 50,000 new diseases per year). After lung and colon cancer it is the third leading course of death.
It occurs with increasing age and is curable in the early, non-symptomatic and non-metastatic stages. There are many treatment options. They range from surgical removal of the whole prostate to regular controls, the "active surveillance".
Recommendations of the specialist societies
The Urological Society recommends a screening using PSA for all men above the age of 50. In case of a positive family history, i.e. if the father or brother are/were affected, the recommendation is to be examined above the age of 45, since there is already a double risk.
The Society of General Practitioners does not recommend an active screening of prostate cancer. PSA tests should only be done on the patients request. The focus should be on explaining the consequences of over-diagnosis and over-therapy.
How to get out of this dilemma
These differing opinions of the specialist societies reflect the complexity of screening and the diagnosis of prostate cancer. How reliable is the PSA value or the result of a digital investigation? Is the biopsie or its repetition always the next step? Must it be treated at all? The better the diagnosis, the better the decisions regarding further procedures can be taken.
The multi parametric prostate-MRI makes an important contribution to this. It shows the structure of the prostate in detail and analyses the metabolism. All these parameters make it possible to detect the tumor, define its size and localization and to estimate its aggressiveness. With this advanced protocol an increase of the diagnostic accuracy up to approx. 92% is possible.
Recommendations for prostata-MRI
We recommend the multi parametric prostate MRI for patients
- with increased PSA value (over 4.0 ng/ml), increasing PSA values or unclear results in the physical examination
- for an accurate planning of a tissue sample (biopsy)
- in case of tumor suspicion after a negative tissue sampling
- to determine the exact size of the carcinoma after a biopsy
- for surveillance
- for the monitoring of therapeutic measures
- for patients seeking the highest level of safety
At Radiology Ottobrunn, multiparametric MRI of the prostate is performed on the "open high-field MRI panorama" and without a rectal coil. It takes approx. 40 minutes. The evaluation is according to the PI-RADS assessment.
A special preparation is not required. Prior to the examination we kindly ask you not to drink coffee or tea and to refrain from smoking.
The gap between a biopsy and a multi parametric prostate MRI should be at least 6 weeks.