Q. Why is MRI required even after a normal prostate biopsy?

Answered by Dr. Shahil Khant and medically reviewed by iCliniq medical review team.


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Hello doctor,

I am 64 years old and I just had my first prostate biopsy. Out of 10 samples, only one contained cancer. Gleason 6 (3+3). DRE normal. PSA 4.4. PSA has gone up and down over four years with 4.5 the highest, 3.75 lowest. Recent 4K score 9%. Recent PCA3 17%. I was relieved with biopsy, but urologist wants to do a follow-up MRI to rule out any hidden cancers.

Why did not he do this before biopsy? Is this insurance related? By the way, my prostate measured 60 grams. I am an active healthy guy. I take Simvastatin for cholesterol and Losartan 100 mg for blood pressure. I just want your advice on why MRI is indicated.

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Dr. Shahil Khant
Andrology, General Surgery, Urology


Welcome to icliniq.com.

  • Yes, you require an MRI (magnetic resonance imaging).
  • Your urologist wants to keep you on active surveillance.
  • So it is better to make sure that there are no other suspicious lesions or foci which may be missed on biopsy.

If no foci then you do not require anything at present just follow up with PSA (prostate-specific antigen).

If there are other foci which are malignant then you may require surgery depending on the stage of disease and hence MRI.

MRI can be done pre or post biopsy.

If your biopsy had shown aggressive tumor then MRI could have been avoided and you would have required surgery directly.

So, he did not do an MRI before. So it is better for you to undergo MRI as you require active surveillance.

For more information consult a urologist online --> https://www.icliniq.com/ask-a-doctor-online/urologist

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