Examination MRI examination of the prostate gland

Before the examination

Sexual activity/ejaculation

Sexual activity, in particular ejaculation, influences the quality of the images of the prostate gland and can make interpretation of the MRI images more difficult. For this reason we ask you to refrain from sexual activity or ejaculation for 4 days prior to your appointment.

No metal

Metal objects in or outside your body are attracted to the strong magnet in the scanner, therefore, you may not enter the MRI examination room with, for example, a wheelchair, keys or coins. Credit/bank cards with a magnetic chip, hearing aids, mobile phones and watches, are damaged when close to the strong magnet in the scanner (the magnet is always switched on!).

Should you (or your companion) have a pacemaker/defibrillator (ICD), a neurostimulator in the spine, aneurysm clips, dentures/teeth with implanted magnetic fastenings, a bladder stimulator or a permanent insulin pump, then you may not enter the examination room. This also applies to foreign metal objects, such as metal splinters (especially in or near the eyes), shrapnel or bullet wounds and older types of heart valves, aneurysm clips or certain cochlear (ear) implants. You may be required to problem.

Clothing and jewelry

Unless otherwise requested by your specialist, you may continue to take any medications and eat and drink normally. Rings and piercings made of gold or silver may be worn as the magnet doesn’t affect these items. All other items of jewellery and watches are best left at home. Please wear comfortable clothing with separate top and bottoms. Should any clothing contain metal parts (e.g. zips or underwired bras) you will be given a gown to wear.

Medications

Usually you can continue to take your medications as prescribed, however your doctor may advise you to temporarily stop taking certain medications. We would advise you to bring your medication passport (available from your pharmacist) or alternatively, make a list of all medications that you are taking at the time of your scan.

Restroom

For an accurate diagnosis it’s very important that your bladder is empty. It’s also very important that there’s no air in your bowel. Therefore we would explicitly ask you to empty your bladder and bowel prior to the MR examination. During the MR examination the technician will insert a small tube into the rectum to remove the remaining air from your bowel. Optionally it’s also possible to insert the tube yourself.

Claustrophobia

People with severe claustrophobia may be anxious about undergoing an MRI scan. Should you have severe claustrophobia, then please inform your specialist or GP of this, as they may prescribe a mild sedative. Even a mild sedative will affect your ability to drive, so please make sure that you make other arrangements for transportation to the hospital.

During the examination

You are required to report to the Radiology Department (Route 780) 10 minutes before the time stated on your appointment card or letter, keeping in mind that it’s a 10 minute walk from the main entrance to the Radiology Department.

The radiographer or assistant will collect you (and your companion) from the waiting area, bring you to a changing room where you (and your companion) will be required to leave all metal objects, telephones, credit-bank cards etc, behind. An intravenous line will be inserted and the procedure will be explained. You may
direct any questions to the radiographer at any time before or during the preparation for your examination.

Buscopan

In all cases it is necessary to administer a medication, Buscopan®, to reduce movement of the bowels and so decrease motion artefacts on the images. This is administered by the radiographer via the intravenous line, just before the start of the examination. You may not receive these medications should you have:

• Increased pressure in your eyes (glaucoma)
• Increased or irregular heart rhythm
• A muscular disease
• Stricture of the colon (large bowel)
• A problem with urination whereby you have to insert a catheter to empty the bladder.

Should you have any queries over this medication you may contact your specialist, radiology department or ask the radiographer during the preparation for your examination.

Contrast Agents

It is possible that a contrast agent may be administered during your scan. This is determined by the specialist and radiologist and allows the differences between organs and tissues on an MRI scan to be seen more clearly. To administer the contrast agent the radiographer will insert a cannula/intravenous line and will remove the cannula at the end of the examination. During the examination the radiographer will administer the contrast agent when you may experience a cold sensation in the arm or a strange taste in the mouth. These sensations only last a few seconds. Rarely do patients have a reaction to the contrast agents used for MRI scans, but should you have had a reaction in the past, please contact the Radiology Department as the radiologist can in consultation with your specialist, take preventative measures. If you have a reduced kidney function we would also request that you contact the Radiology Department.

In the MRI examination room

When you enter the MRI examination room, you will be required to lie on the scanner table. To detect the tiny radio signals that are emitted from the body, a ´receiving device´ is placed behind or around the area to be examined. You will be given a rubber ball to hold onto during the scan. This is the alarm bell and the radiographer will instruct you as to when you can use for any emergency. On hearing the alarm, the radiographer will check on you and remove you from the scanner if necessary.

The part of your body being examined is placed in the middle of the scanner (an open-ended, cylinder-shaped machine about a one and a half metres long). During the examination you will hear different kinds of loud noises (knocking/buzzing) but will be given earplugs or headphones to wear. If you wish you may listen to the radio. During the examination many images are taken. Some images only take a few seconds to make, others several minutes. Once the noise has stopped, then one set of images have been made. During the making of the images and the time in between, you will be required to lay very still. Once all the images have been made the radiographer will slide you out of the scanner and remove the intravenous line. The whole examination takes on average, around 30 minutes, but in some cases can take up to an hour or longer.

Results PI-RADS

Your prostate MR images are evaluated by a specialized radiologist using the PI-RADS score. With this assessment, the radiologist determines the likelihood of the presence of prostate cancer. The PI-RADS score is classified in a categories form 1 to 5.

Overview of PI-RADS scores (the likelihood of prostate cancer):

1. very low (very unlikely)
2. low (unlikely)
3. intermediate (unclear)
4. high (probably present)
5. very high (very likely present)

Your practitioner will discuss the results of the MRI with you during your next appointment.