Prostate examination using MRI

introduction

Magnetic resonance tomography is one of the leading procedures for preventive examinations, diagnosis, and therapy planning and implementation in relation to prostate diseases - above all prostate cancer: 85% of all prostate cancer cases can be detected with the help of MRI.

If, on the other hand, there are no specific changes in the prostate in the MRI, these are actually excluded with a 90% certainty.

The MRI of the prostate is - even before the ultrasound, the elastography and the punch biopsy - as safest diagnostic tool.

Another benefit of MRI imaging is theirs non-invasive, painless Property as well as the lack of radiation exposure (in contrast to the CT or conventional roentgen).

But not every disease of the prostate is an indication for an MRI examination, precisely because it is, among other things, a very costly process acts.

Indications for an MRI of the prostate

In contrast to CT or X-rays, MRI is particularly suitable for Soft tissue imaging and with it the prostate.

The sectional images generated by means of a magnetic field allow conclusions to be drawn about the morphology, the Blood circulation (as well as possible bleeding), Calcifications and in the end with it too benign or malignant changes to pull the prostate,

The most important indication or the most important field of application of the prostate MRI is Diagnosis around the Prostate cancer.

On the one hand, this includes Early detection procedures: fall increased PSA levels or the doctor puts a suspicious Palpable findings found during the physical examination, can by means of the MRI a malignant change can be detected or ruled out so that an unnecessary biopsy may be avoided.

On the other hand, it can MRI targeted planning for a possibly necessary punch biopsy in the event that the PSA value continues to rise despite previous biopsies without evidence of cancer.

Read more about this topic here: biopsy

However, if prostate cancer has already been detected, that serves MRI then the Assessment of the exact extent and the progress of the disease in the pelvic area as well as further therapy planning and control of the course of therapy.

Finally, it can also be used to search for a possible recurrence after treatment for prostate cancer has already taken place.

An MRI image, on the other hand, makes less sense if a Prostate inflammation (Prostatitis) prevails because it makes it difficult to identify any malicious changes that may be present.

A simple, benign prostate enlargement (benign prostatic hyperplasia; BPH) is also not an indication.

procedure

In preparation for the MRI scan of the prostate, the patient is usually asked to do so approx. 4 hours before the start of the examination stop eating food.
Small amounts of water and any necessary tablets, however, can be taken beforehand as usual.

Shortly before the start of the examination, the patient is asked to do all metallic objects (Jewelry, watches, piercings, dentures, hair clips etc.) and to get rid of clothes with metallic components (e.g. underwired bra, buttons, zippers etc.). The underwear and usually a (metal-free) T-shirt can remain on.

Next, the patient is asked to do the Completely empty the urinary bladderin order to achieve the best possible imaging.

After the patient is in Supine position placed on the examination table, on which it will later be pushed into the MRI tube for imaging headphone against the loud knocking noises of the device and a Emergency bell enough.

Usually a Indwelling cannula placed in the elbow vein for a possibly necessary Administration of contrast medium for the MRI of the prostate before or during the examination.

In order to avoid image disturbances and to improve the image quality, it may also be necessary to administer a drug that relaxes and calms the bowel movements (e.g. Buscopan®).

Duration

The duration for a MRI scan of the prostate amounts on average to a period of approx. 30-40 minutes, individual deviations are always possible.

Cost of an MRI of the prostate

The costs of a pure prostate MRI examination and thus a pelvic representation amount to an amount of approx. 800-900 € for privately insured persons (billing according to GoÄ).
The costs of statutory insurance are lower and are covered by a doctor if prescribed.

However, the costs can vary individually, depending on what additional costs such as B. a contrast agent or medication added.

The costs incurred for private patients are fully covered by private health insurances.

The statutory health insurance companies usually also cover the costs for an MRI examination of the prostate, as this is included in the associated service catalog.

The indication must correspond to the S3 guideline on prostate cancer (prostate cancer) in the areas of early detection, diagnosis and therapy of the various stages of prostate cancer.

Special forms of MRT examinations, such as MR spectroscopy or MRT-assisted punch biopsy, on the other hand, are not covered by statutory health insurances, but are offered as so-called individual health services (IGEL) that are fully covered by the patient (all costs, including the MRI). have to be paid for yourself.

Private health insurances usually even undertake the examinations that statutory health insurers consider to be an IGEL service.