About a multiparametric prostate MRI scan
A multiparametric MRI (mpMRI) combines three kinds of MRI picture of the prostate: detailed anatomical pictures, pictures showing how freely water moves in the tissue (diffusion), and pictures taken while a contrast dye passes through the gland (dynamic contrast enhancement), which show blood flow. Together these give the most complete MRI assessment of the prostate. It uses a strong magnetic field and radio waves, not X-rays.
In the UK, NICE recommends an mpMRI as the first test for men referred with suspected prostate cancer, usually after a raised PSA blood test or an abnormal prostate examination. The radiologist gives the scan a score from 1 to 5 (a PI-RADS or Likert score) for how likely it is that there is a cancer that needs treatment. A low score may mean a biopsy can be avoided; a higher score usually leads to a biopsy targeted at the area seen on the scan. If cancer is found, the scan can also show whether it has spread outside the prostate. mpMRI is less likely than a biopsy alone to pick up slow-growing cancers that would never need treatment.
The price shown includes contrast, if required. You can also read our guide to mpMRI for the prostate and our article on prostate cancer. For a standard prostate scan, see prostate MRI.
What happens during the scan
You lie on your back on the scanner bed with a coil placed over your lower abdomen; no probe is placed in the back passage. The scanner is loud, so you will wear ear plugs or headphones, and the radiographer can talk to you throughout. You need to keep very still. Some centres give an injection of Buscopan (hyoscine butylbromide), a medicine that briefly slows the movement of the bowel so the pictures are sharper.
Partway through the scan, contrast dye (gadolinium) is injected through a small cannula in a vein in your arm. You may be asked to wait for a short time afterwards.
What the scan can show
A multiparametric prostate MRI can help to look at:
- prostate cancer that may need treatment, after a raised PSA test
- whether a biopsy is needed, and which area to target
- whether a cancer has spread outside the prostate or to nearby lymph nodes
- changes over time in men on active surveillance
- suspected recurrence after treatment
Preparing for your scan
Follow the instructions the centre gives you when you book. Some centres ask you to empty your bowels before the scan or give you a small enema, and some ask you to avoid ejaculating for 2–3 days beforehand, as this can help show the seminal vesicles more clearly. You can usually eat and drink normally.
If Buscopan may be used, tell the centre if you have glaucoma, heart problems, myasthenia gravis or difficulty passing urine. Buscopan can cause blurred vision for a short time, so do not drive until your eyesight is back to normal. Tell the centre if you have had a hip replacement, as metal hips can affect the pictures of the prostate. Upload your recent PSA results and any previous biopsy or scan reports when you book.
As contrast is used, tell the centre if you have kidney problems, asthma or allergies, or have had a reaction to contrast dye before.
You can usually eat, drink and take your normal medicines unless the scanning centre tells you otherwise. Wear loose, comfortable clothing without metal zips or buttons, and leave jewellery at home. You will be asked to remove metal items such as hair clips, hearing aids, coins and keys, and you may be asked to change into a gown.
Before the scan you will complete a safety questionnaire. Tell the team if you have a pacemaker, any metal implant, surgical clips or other device, if you have kidney problems or allergies, or if you are, or might be, pregnant or breastfeeding. If you feel anxious in enclosed spaces, let us know when you book. Some centres can offer a relaxant, and if you take one you will need someone to take you home and must not drive for 24 hours.
Frequently asked questions
What does my PI-RADS or Likert score mean?
The radiologist scores the scan from 1 to 5 for how likely it is that there is a cancer needing treatment: 1–2 unlikely, 3 uncertain, 4–5 likely. With a score of 1 or 2 you may be able to avoid a biopsy and have PSA checks instead; with 3 or more a biopsy is usually offered. Your doctor will explain what your score means for you.
If my scan is normal, can I avoid a biopsy?
Often, yes. With a low score you and your doctor may decide on regular PSA tests instead of a biopsy, taking into account things like your age, family history and PSA level. No test is perfect, so keep up any follow-up your doctor recommends.
Is contrast included in the price?
Yes. The price for this scan includes contrast if it is required.
Do I need a referral?
You can tell us if you have a referral from your GP, physiotherapist or consultant and upload it when you book. If you do not have one, select “no referral” when you book and the scanning centre will confirm the next steps with you.
Sources
- NICE – Prostate cancer: diagnosis and management (NG131)
- Prostate Cancer UK – MRI scan
- Cancer Research UK – Multiparametric MRI (mpMRI) scan for prostate cancer
- NHS – PSA test
- NHS – MRI scan
The information on this page has been gathered from various sources and is provided for general information only. It is not medical advice. TOP MRI is not liable for the accuracy or completeness of this information. Please speak to your doctor or the scanning centre about your own situation.