What is a multiparametric MRI of the prostate?  

The prostate is a walnut-sized gland (known as the prostate gland) located below the bladder in men. It produces an important component of seminal fluid and is therefore crucial for fertility. Since it surrounds the urethra and acts as a muscular valve to separate the urinary and seminal pathways, a prostate condition—such as inflammation, enlargement, or prostate cancer—can affect urine flow.

Multiparametric MRI (mpMRI) of the prostate is a modern, high-resolution imaging technique used for the early detection and accurate diagnosis of prostate cancer. It combines various MRI sequences to distinguish benign changes from clinically significant tumors. mpMRI plays a key role prior to a prostate biopsy and in cases of unclear PSA levels.

No. A prostate mpMRI is a non-invasive and painless procedure. During the MRI, you will lie comfortably on an examination table. The only sound you will hear is the typical loud knocking noise, for which you will be provided with ear protection.

In most cases, no special preparation is required. Before the examination, we will ask about any medical devices you may have, such as a pacemaker, or any relevant pre-existing conditions. Depending on the nature of the examination, it may be necessary to adjust certain medications at short notice. You will receive detailed instructions prior to your appointment.

No. An MRI uses a strong magnetic field—there is no exposure to X-rays or ionizing radiation. The procedure is therefore considered particularly gentle.

In many cases, a normal mpMRI can help avoid an unnecessary biopsy. However, if the scan reveals suspicious areas, it enables a targeted MRI-guided or fusion biopsy. This increases the success rate and improves the diagnosis of prostate cancer.

Yes. The diagnostic value of prostate MRI depends largely on state-of-the-art equipment, standardized examination protocols, and the expertise of specialized radiologists (Q1/Q2 certification in prostate MRI interpretation by the German Radiological Society). Structured interpretation according to international PI-RADS criteria is essential for reliable diagnosis. You’ll find all these factors right here in our practice!

Prostatitis (inflammation of the prostate) should be evaluated by a urologist. Typical symptoms include pain in the pelvic area, difficulty urinating, or fever. Treatment depends on the cause; antibiotic therapy is often prescribed (e.g., for bacterial inflammation). In cases of nonbacterial prostatitis (chronic pelvic pain syndrome), however, symptom relief can also be achieved through heat therapy, physical therapy, relaxation exercises, and, if necessary, medication. There is also a form of prostatitis that is symptom-free (asymptomatic prostatitis).

Benign prostatic hyperplasia (BPH) is a common cause of urinary symptoms. Depending on the severity, treatment options may include medication, minimally invasive procedures, or surgery. Early diagnosis, for example via MRI, can help rule out other causes such as prostate cancer and enable targeted, follow-up urological treatment.

No. At our practice, prostate MRI scans are performed without inserting a coil into the rectum.

Instead, we use state-of-the-art MRI technology with special external receiver coils placed on the pelvic area. This allows us to produce high-quality, detailed images of the prostate without the need for an additional rectal examination.

After a prostate biopsy, you should generally wait about 4 to 6 weeks before having a prostate MRI. The tissue samples taken cause minor bleeding in the prostate, which may be visible on the MRI and make it difficult to interpret the results. Once enough time has passed, we can evaluate the images much more reliably.

In some cases, the exact timing can be determined on an individual basis in consultation with the treating physician.

In most cases, we use a contrast agent for prostate MRI, which is administered through a vein in the arm. This allows for a more accurate assessment of blood flow and tissue structure in the prostate.

The advantage is that suspicious areas can often be identified more easily and distinguished more reliably from benign changes. This increases the diagnostic value of the examination.

The MRI contrast agent used is generally very well tolerated. We will determine on a case-by-case basis whether to use it in your case prior to the examination.

Yes, in most cases, a prostate MRI is perfectly feasible even for patients with claustrophobia. Our MRI machines have a particularly wide opening, so many patients find the exam much more comfortable. In addition, you’ll be connected to our team via an intercom system throughout the entire exam.

If you still feel very anxious about the examination room, we can discuss additional ways to help you feel more comfortable before the exam.

PI-RADS is a standardized scoring system for prostate MRI. Radiologists use it to describe how abnormal an area of the prostate appears on an MRI scan and how likely it is that this area could conceal a significant change in the prostate that requires treatment.

Ratings are given on a scale of 1 to 5:​

• PI-RADS 1–2: A significant lesion is highly unlikely.
• PI-RADS 3: Indeterminate finding – follow-up; further evaluation may be advisable.
• .PI-RADS 4–5: A significant finding is increasingly likely.

Important: PI-RADS is not a definitive diagnosis, but rather an assessment of the imaging findings. The next steps will always be determined in consultation with your treating urologist.

Standard prostate screening typically consists of a PSA blood test and a digital rectal exam performed by a urologist. While these tests can provide indications of abnormalities, they do not provide direct images of the prostate.

In contrast, prostate MRI produces highly detailed images of the entire prostate. This allows changes in the tissue to be detected earlier and more accurately, and their location to be pinpointed with precision. Another advantage is that areas that are difficult to reach during a digital rectal exam—such as the front part of the prostate or the tip—can still be clearly assessed using MRI.

If a tissue sample is needed, MRI can also help pinpoint suspicious areas, allowing for more precise planning of a potential biopsy.

The written report of your prostate MRI is usually available promptly (typically within 48 hours). We will then discuss the results with you as soon as possible.

In addition, the results will be sent to your treating urologist. He or she will discuss the next steps with you and work with you to decide whether, for example, a follow-up visit, further testing, or, if necessary, a targeted biopsy is appropriate.

The Q1 and Q2 certifications are quality certifications issued by the German Radiological Society (DRG) for radiologists who interpret prostate MRIs. They confirm specialized training and experience in evaluating this type of examination.​

• Q1 Certification: Evidence of structured continuing education and experience in interpreting prostate MRI scans.
• Q2 Certification: A higher qualification level requiring extensive experience and a larger number of evaluated studies.

For you as a patient, this means that the examination and interpretation of results are performed by specially trained radiologists in accordance with high-quality standards.

A prostate MRI may be recommended if you have an increased personal risk or if your screening results are abnormal. This includes, for example, elevated or rising PSA levels, an unclear digital rectal exam by a urologist, or abnormal results from previous examinations.

Even if there is a family history of the disease—for example, if close relatives have had prostate cancer—an MRI may be useful for early and more accurate diagnosis.

The advantage of an MRI is that it provides detailed images of the prostate without causing pain or exposing the patient to radiation, and can detect potential changes at an early stage.

For the examination, you will usually be given a medication (Buscopan) that reduces bowel movements and thus improves image quality. After taking this medication, you should not drive on the day of the examination.

We therefore recommend that you arrange for someone to drive you home or use public transportation.