Prostate MRI

Multiparametric 3T prostate MRI combining anatomical, diffusion-weighted, and contrast-enhanced sequences for PI-RADS assessment of suspicious lesions. Guides biopsy targeting and active surveillance.

Prostate MRI at Private Access Wien uses the Siemens MAGNETOM Verio 3 Tesla scanner to perform multiparametric imaging of the prostate gland following international PI-RADS (Prostate Imaging Reporting and Data System) standards. The higher field strength is particularly advantageous for prostate imaging: improved signal-to-noise ratio enables precise delineation of the peripheral zone, transition zone, and central gland, where clinically significant cancers most commonly arise. The examination integrates three complementary imaging sequences. T2-weighted anatomical imaging provides detailed zonal anatomy and lesion morphology. Diffusion-weighted imaging with apparent diffusion coefficient (ADC) mapping quantifies tissue cellularity — areas of restricted diffusion (low ADC signal) are strongly associated with high-grade cancer. Dynamic contrast-enhanced sequences assess lesion vascularity and enhancement kinetics, capturing the early wash-in and late wash-out patterns characteristic of malignant tissue. Each identified lesion is assigned a PI-RADS score from 1 to 5 based on the most suspicious sequence findings. PI-RADS 1–2 indicates very low probability of clinically significant cancer; PI-RADS 4–5 warrants targeted biopsy. This structured reporting guides urologists in deciding between continued active surveillance, targeted MRI-fusion biopsy, or systematic biopsy, significantly improving cancer detection accuracy compared to random-template biopsy alone. The examination is commonly requested for men with elevated PSA, those with prior negative biopsy but persistent clinical suspicion, patients already under active surveillance for low-grade disease who need restaging, and as pre-biopsy planning to improve targeting. An intravenous contrast agent (gadolinium) is administered. Patients should arrive with a comfortably full bladder if possible. The scan takes 40 to 50 minutes.