Evaluation of Diagnostic Value of 3-T Magnetic Resonance Imaging (MRI) in Suspected Prostate Cancer

Evaluation of Diagnostic Value of 3-T MRI in Suspected Prostate Cancer

The purpose of the study is to evaluate the usefulness of 3-T magnetic resonance imaging (MRI) in the evaluation of suspected prostate cancer. Men with suspected prostate cancer based on serum prostate-specific antigen antigen (PSA) value are included. Men are randomized to pre-biopsy MRI or no MRI groups in ratio 1:1. Standard transrectal ultrasound guided biopsies will be taken in addition to extra biopsies from lesions suspicious based on MRI evaluation. Hypothesis is that more prostate cancers will be found after MRI evaluation.

Inclusion Criteria:

• Informed consent
• Suspected prostate cancer based on PSA value (total PSA 2,5-10 ng/ml and PSA free to total ratio <=0.15, or total PSA 10-20 ng/ml)
• PSA and serum creatinine measurement less than 60 days before transrectal ultrasound-guided prostate biopsies
• No evidence of PSA increase by non-cancerous factors (catheterization, bladder stones, urinary tract infection including bacterial prostatitis)

Exclusion Criteria:

• Previous prostate biopsies
• Previous prostate surgery
• Contraindication for MRI (such as pacemaker or inner ear implant)
• Claustrophobia
• Estimated glomerular filtration rate (eGFR) <40 ml/min
• Suspected clinical T3-T4 prostate cancer based on digital rectal examination
• Contraindication for transrectal ultrasound-guided prostate biopsies
• body mass index >30