Since the introduction of Prostate Specific Antigen (PSA), which is a protein produced by prostate cells, detection of prostate cancer is performed in early and advanced stages less.
The only method to demonstrate the presence of neoplastic cells in the prostate is a biopsy. This is performed under local anesthesia or sedation, transrectal or perineal approach and with the help of an ultrasound machine. The disadvantage of this technique is the low diagnostic specificity of prostate specific antigen (PSA) and, in addition, ultrasound can hardly detect suspicious areas of cancer. This leads that have to perform multiple biopsies are negative continuously with a progressive rise of PSA.
In this situation, the urologist should ask when proposing to make a new biopsy (as this is not without risk) and how to interpret the result of it in case it is negative, the possibility of being a false negative.
There is currently a test image which reduces the number of biopsies performed well also reduce the possibility of false negative results. This test is the Multiparameter Magnetic Resonance (RMM) and has higher sensitivity for the detection of aggressive cancers in the prostate. It also allows sampling guide and influence the most suspicious areas, reducing the probability of obtaining a false negative result.
The multiparameter magnetic resonance (RMM) of the prostate is the practice of a morphological sequence T2 (define the shape, size and boundaries of the prostate) and three functional sequences DWI, DCE, MRS (diffusion, contrast and spectroscopy) studying respectively tissue density, uptake of the same contrast and metabolic activity. All these parameters are collected in a score and give rise to a report categorized by PI-RADS system in relation to the segmented zonal anatomy of the prostate.
When a multiparameter magnetic resonance (RMM) done?
The multiparameter magnetic resonance (RMNm) is indicated in the following cases:
- The local staging of prostate cancer already known, to select the most optimal treatment.
- The persistence of suspicion for elevated Prostate Specific Antigen (PSA), with previous negative prostate biopsy and biopsy new indication.
- Control back to local recurrence of prostate cancer treatment.
The ResonanciaMagnéticaMultiparamétrica (RMM) lasts approximately 40 minutes. You must place a venous access for infusion of contrast and endorectal device is placed; although you can also go with (not endorectal) external coil. No anesthesia or sedation required.
This imaging technique, along with the emergence of new specific markers, has been a breakthrough in the field of diagnosis and management of prostate cancer, since it allows more accurate diagnosis of patients affected by this tumor and better monitoring of patients with elevated Prostate specific antigen (PSA).