Referral Form
Click here to download the referral form.
- Please provide appropriate clinical information in terms of PSA levels / serial levels / DRE findings / Previous prostate related investigations and treatment
- Please tick the MRI safety related questions
- Email the form to info@theprostatescan.com
- Please use encryption to keep the patient related information safe
- Please provide legible contact details for yourself. This will help us liaise with you should further information be required and the report is sent to you swiftly and correctly
- Please provide patient contact information in a legible way including mobile telephone number and if possible email address so that we are able to get in touch with them quickly and efficiently
Resources for clinicians
What does the NICE guideline say
As per the latest NICE guideline 2014), pre-biopsy MpMRI is not recommended. It states the following onMpMRI scan of prostate:
- Consider multiparametric MRI (using T2- and diffusion-weighted imaging) for men with a negative transrectal ultrasound 10–12 core biopsy to determine whether another biopsy is needed
- Consider multiparametric MRI, or CT if MRI is contraindicated, for men with histologically proven prostate cancer if knowledge of the T or N stage could affect management.
- Consider MpMRI before enrolling a patient into active surveillance to get baseline imaging
- If there is concern about clinical or PSA (prostate-specific antigen) changes at any time during active surveillance, reassess with multiparametric MRI and/or rebiopsy.
PROMIS Trial
Diagnostic accuracy of multiparametric MRI and TRUS biopsy in prostate Cancer (PROMIS): a paired validating confirmatory study
Multicentre, paired cohort, confirmatory study to test diagnostic accuracy of MP-MRI and TRUS-biopsy against a reference test (Template prostate mapping biopsy). Men with raised PSA upto 15ng/ml, with no previous biopsy underwent 1.5Tesla Mp-MRI followed by both TRUS and TPM biopsy.
Findings / conclusion / interpretation:
- For clinically significant cancer, MpMRI was more sensitive than TRUS biopsy (93%)
- For clinically significant cancer, MpMRI was less specific than TRUS biopsy (41%)
- MpMRI has a high negative predictive value (89%) for clinically significant cancers. This indicates that a negative MpMRI result implies high probability of no clinically significant cancer
- Using MpMRI to triage men might allow 27% of patients avoid a primary biopsy and diagnosis of 5% fewer clinically insignificant cancer
- If subsequent TRUS biopsy were directed bMpMRI findings, up to 18% more cases of clinically significant cancers might be detected compared to conventional pathway of TRUS biopsy for all
- MpMRI, used as triage test before first prostate biopsy, could reduce unnecessary biopsies by a quarter
- MpMRI can also reduce over diagnosis of clinically insignificant prostate cancer and improve detection of clinically significant cancer
- Small number of clinically significant cancers can be missed in MpMRI