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Why is MRI required even after a normal prostate biopsy?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. K. Shobana

Published At February 2, 2018
Reviewed AtFebruary 14, 2024

Patient's Query

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 and 3.75 lowest. Recent 4K score 9 %. Recent PCA3 17 %. I was relieved with the biopsy, but the urologist wants to do a follow-up MRI to rule out any hidden cancers. Why did he not do this before the 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.


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 there are no foci, then you do not require anything at present just follow up with PSA (prostate-specific antigen). If there are other foci that 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 an 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.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Khant Shahil Ramesh Bhai
Dr. Khant Shahil Ramesh Bhai


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