Prior to your MRI Guided prostate biopsy, you will have undergone a Multiparametric MRI of the prostate. Multiparametric MRI of the prostate (mpMRI) is an advanced form of computer imaging which looks in detail at the prostate and surrounding areas. mpMRI improves visualisation of the prostate, its substructure, surrounding tissue and most importantly focal lesions or cancer. This is a relatively new technology, is very sensitive and can detect up to 90% of significant prostate cancers.
Dr Swindle will target the lesion identified on your mpMRI when he performs an MRI Guided prostate biopsy. The MRI Guided biopsy involves the use of a state of the art MRI machine to identify suspicious looking areas in your prostate and then allows Dr Swindle to biopsy specific parts of the prostate with great accuracy. In general, an MRI guided prostate biopsy is performed in men with an abnormal PSA, a palpable abnormality on a digital rectal examination (DRE) or a rapidly increasing PSA level who may or may not have had a previous negative ultrasound guided biopsy but have also had an abnormal focal MRI finding.
After you have been reviewed by the Radiologist and MRI technician you will be taken into the MRI room. A drip will be placed in your arm and you will be given IV antibiotics. The MRI scan will begin and Dr Swindle will insert a probe whilst a series of images and measurements are taken and the volume of the prostate is calculated.
The MRI technician will position you on the table of the scanner. You will need to remain as still as possible. Through the procedure you may be able to hear and talk to the technologist who will be monitoring the examination from an adjacent room. The magnet makes a knocking and humming sound when scanning. When the knocking stops, the computer processes the images for a few seconds before the next scan. It is important not to move or change position.
A fine biopsy needle is then loaded through the ultrasound probe to take multiple specimens of prostate tissue. The specimens will be sent to a pathologist for assessment. As you will be lightly sedated during the procedure you will feel no discomfort.
Following the procedure you will be taken back to recovery where you will still be in your bed and the nursing staff will monitor very closely your pulse, blood pressure and breathing.
You will be monitored here for approximately 20 minutes. When the nursing staff are happy with your recovery you will be dressed and then placed in the lounge area for a further hour or so where you will be offered some refreshments. When the staff are happy with your recovery you will be allowed to leave.
You will need to be accompanied to and from the procedure as you will not be able to drive after the light sedation and you should not be alone the night of the procedure. You should avoid strenuous activity for 24 hours and should not work the following day. You should not make any major decisions or sign any legal documents for 24 hours after the procedure. This is not because of the procedure itself but as a result of undergoing a sedation.