Prostate Imaging

A National Leader in Advanced Prostate Imaging and Diagnosis

When caught early, prostate cancer is highly treatable. One in nine men will be diagnosed with prostate cancer in his lifetime, making it the second most common cancer among men (after skin cancer). If you or a man you know receives results from a standard PSA screening or digital rectal exam that indicate the possibility of prostate cancer, VCU Health Radiology’s Advanced Prostate Imaging team’s advanced screening and biopsy techniques will increase the success in locating prostate tumors and help accurately stage the disease to set up a clear path to treatment.

The VCU Department of Radiology Advanced Prostate Imaging service is one of the few places in the country that employs the most advanced, accurate and comprehensive prostate MRI diagnostic and imaging guided biopsy techniques.

Advanced Prostate Imaging

VCU Health was one of the first academic medical centers to perform advanced imaging and image-guided biopsies of the prostate. Today, we have mastered the art and science of these procedures and are highly successful at screening, accurately detecting, diagnosing, staging and treating prostate cancer.

Advanced prostate imaging is performed through our brand new 3T magnetic resonance imaging (MRI), which uses powerful magnets and radio waves to create detailed images of the prostate. The procedure, in which the patient lays on a table that glides into a tube-shaped machine, is safe and radiation-free, and – aside from an injection of a contrast agent – is non-invasive. Much as someone would have a MRI to investigate the cause of back pain, the technology gives doctors eyes on what is happening in prostate tissue.

Reasons for advanced prostate imaging:

• Detection: Although a patient may have had multiple negative biopsies, he can still have an elevated PSA (Prostate-Specific Antigen) level in his blood. An elevated PSA may suggest a tumor is present.  An advanced prostate MRI procedure is used to detect its location and where the biopsy (removal of a tissue sample) will then be performed. During this non-invasive, 30 minute examination, we will perform multiple advanced imaging sequences at 3T without endorectal coil.
• Improving biopsy targeting: Traditionally, up to 66% of initial TRUS biopsies are unable to locate a tumor. The information from a prostate MRI can help guide a targeted biopsy to increase the likelihood of a positive biopsy yield.  Increasingly, urologists are considering prostate MRI pre-biopsy for more precise biopsy targeting. Increasingly, urologists are using more and more pre-biopsy prostate MRI because if it is positive, an imaging guided biopsy will be added to the same session of the TRUS prostate biopsy, which will improve the tumor detection rate significantly.
• Staging: MR imaging gives an accurate understanding of the progress (“stage”) of the prostate cancer, which is crucial for determining the appropriate therapy and treatment plan. 
• Preoperative roadmap: For men with newly diagnosed prostate cancer, advanced preoperative prostate imaging is routinely used to assist surgeons in planning minimal invasive surgery and radiation oncologists in planning a more targeted therapy. Advanced preoperative prostate imaging techniques gives surgeons a roadmap of the location of the tumor as well as the relationship between the tumor and the surrounding important structures. The roadmap guides surgeons to remove the cancer and enables them to more accurately decide when to remove or spare the delicate arteries and nerves that lie next to the prostate which may affect urinary continence and sexual function.
• Finding recurrent cancer: For patients who have been treated for prostate cancer, advanced prostate imaging is an important tool for detecting potential recurrence of the cancer. When an increase in the level of PSA has been seen after radical prostatectomy or radiation therapy, it raises the possibility of recurrent tumor. It is very important to know the location of any recurrence so the treatment can be targeted specifically to the recurrence without excessive impact to adjacent normal tissues such as the rectum or bladder.
• Active surveillance: Based on tumor location and staging, some men with low risk of advancing disease may elect active surveillance (also referred to as “watchful waiting”) which implies no aggressive treatment of prostate cancer at the time of diagnosis. Active surveillance will include serial PSA testing, advanced prostate imaging and possible repeat biopsies over time to monitor any changes and re-evaluate treatment options.

About an advanced MRI prostate imaging procedure

The MRI prostate imaging procedure poses almost no risk to the average patient and is pain-free. The exam may require patients to receive an injection of contrast material called gadolinium into the bloodstream. It is an iodine-free solution that can be used safely in patients with iodine contrast allergies.

During the exam, you will lay flat on a table and glide slowly into a tube, where you will remain still while the images are being recorded. The image-recording process lasts only a few seconds or minutes. You will be able to relax between imaging sequences, but will be asked to maintain your position as much as possible. The entire procedure can take about 30 minutes.

After the procedure

Highly trained radiologists at VCU Health will interpret your results and communicate them to your physician. Our team is specialized in the interpretation of prostate MR imaging, providing you with the greatest level of expertise.

If presence of cancer is found, prostate MRIs will detect the stage of prostate cancer, can assist surgeons in planning minimally invasive surgery, and help radiation oncologists plan a more targeted therapy.

Testimonials

I am so thankful to everyone at VCU, the entire team was helpful. Not only were they able to detect and biopsy the cancer, but also the staff helped with my trip [to Richmond]. I found VCU Medical Center on the internet because I knew that I wanted to go to an advanced center that was able to do all the latest MRI procedures, including imaging guided biopsy. They were able to schedule me on short notice and plan for the screening MRI at Stony Point one day and do the MR guided biopsy at the downtown center the very next day. The staff even told me about the Hospital Hospitality House, where I stayed. I would recommend advanced Prostate MR Imaging at VCU for everyone who needs it.

Patient K.C. - Florida

About the team

The VCU School of Medicine’s Professor and Director of Oncologic and Prostate Imaging Jinxing Yu, M.D., Assistant Professor Sarah G. Winks, M.D., and other specialized abdominal radiologists at VCU are highly trained in advanced imaging techniques and biopsies of the prostate gland. The team works closely with the urologists and radiation oncologists to provide the latest, most advanced diagnostic tools for prostate imaging, resulting in more accurate detection of prostate cancers.