Magnetic resonance imaging (MRI) is the best method for determining the local spread of prostate cancer. In the past decade, prostate MRI has developed vastly owing to multiple‑parameter techniques, such as diffusion imaging, dynamic angiography and spectroscopy. Combined with these techniques, MRI has been ascertained to be the best currently available prostate cancer imaging method. MRI is the most effective imaging method for detecting tumors in the peripheral zones of the prostate, in particular.
At Docrates Cancer Center, multiple‑parameter prostate imaging is enhanced using a thin, magnetic endorectal coil. With a pre-biopsy MRI scan we can usually precisely target the site for needle biopsy. In ordinary ultrasound-guided examination, the biopsy is basically performed blindly. Saturation biopsy is performed if a visible tumor cannot be accessed with ordinary methods or no tumor is detected by MRI despite a strong suspicion of cancer. Saturation biopsy is performed under general anaesthesia or spinal anaesthesia.
It is important to get a reliable picture of the extent of the cancer in the prostate. In particular, we assess the relationship of the cancer to the prostate capsule. This is of great importance for the planning of treatment. An MRI scan shows whether the cancer has spread beyond the prostate. An MRI scan is therefore always required before making the final decision on prostatectomy surgery or radiotherapy. If the cancer spreads to the sphincter area, its surgical removal is particularly difficult. The sphincter may be damaged during surgery, or it may be impossible to completely remove the cancer tissue when trying to protect the sphincter muscle. In such cases, targeting radiotherapy in the urethra area is a more comprehensive solution and a more likely cure. Radiotherapy can also eliminate cancer cells located outside the capsule more thoroughly in a targeted fashion.
MRI is always utilised in planning the targeting of radiotherapy. If an MRI scan shows that the cancer has spread to the seminal glands, this must be observed in radiotherapy by targeting a larger dose of radiation to the seminal glands. Including hormonal therapy in the treatment is always considered if risk factors for cancer recurrence, such as local spreading, are detected.