A standard MRI scan creates an image of an internal organ. But unfortunately, it is rarely clear enough to confidently diagnose early prostate cancer. That’s where mpMRI, or multi-parametric magnetic resonance imaging, is different. By combining up to three different types of scan, we can get a clearer picture of what’s going on in the prostate. Also, an injection of a contrast agent means that scan images can be enhanced making it clearer to see if cancer is present or not.
Why do we need a new diagnostic?
For over 30 years, the only way to diagnose prostate cancer, and determine whether or not it needs treating, has been based on the results of a random TRUS biopsy. This involves using a series of needles that randomly sample tissue across the prostate, to see whether or not it contains any cancerous cells.
The problem is that because there are gaps between the needles, sometimes significant cancers can be missed if that section of tissue isn’t sampled. The other problem is that although biopsies are a key part of diagnosis, they are invasive and painful, and can sometimes lead to serious infections – so we only want men to have them if they need them. Finding a way to improve the number of aggressive prostate cancers that get caught in time, whilst reducing the number of men who have biopsies unnecessarily, is really important. Multi-parametric MRI can do both of these things as well as ensuring that the biopsies that do happen are able to be much more targeted to where the cancer actually is in the prostate.
The challenge we face calling for UK-wide access to mpMRI
It takes a good deal of skill and expertise to effectively conduct and interpret mpMRI scans for everyone involved, from the radiographer conducting the scan, to the radiologist interpreting it, over to the urologist deciding what to do on the basis of that result. Accurate interpretation and confidence in this technique amongst all the clinicians involved is crucial if we are to be sure that this technology will benefit men.
Also, MRI scanners are in high demand across the NHS, which means that some hospitals may struggle to have the capacity to conduct mpMRI scans before biopsies with the current number of scanners they have. And we know that there are simply not enough radiologists and radiographers in place to meet the mpMRI scan needs of all the men with suspected prostate cancer.