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Imaging scans are valuable tools that help doctors see what’s happening inside your body. Different types of imaging show different details of parts of the body, and they can help your healthcare team make important decisions about your care.
While imaging cannot diagnose prostate cancer on its own, it plays a key role in helping doctors understand the stage of the cancer, plan treatment, and predict possible prognosis (outcome). Only a biopsy — when a small sample of prostate tissue is examined under a microscope — can confirm a diagnosis of prostate cancer.
Imaging scans provide extra information that can help guide your care. Your doctor may recommend imaging if you have abnormal results from a digital rectal exam (DRE) or a prostate-specific antigen (PSA) blood test. Depending on your situation, your doctor might suggest one or more of the imaging tests described below.
An MRI uses strong magnets and radio waves to create detailed images of the inside of your body. Getting an MRI usually means lying still on a table that slides into a large, tube-shaped machine, where you may hear loud tapping or thumping sounds as the scanner takes pictures.
MRI scans can show the prostate gland and the surrounding parts of the body, such as bones, lymph nodes, and nearby organs. This helps doctors check if these structures look healthy or if there are any changes that need attention.
MRI is often one of the first imaging tests your doctor may order when prostate cancer is suspected. This scan provides clear pictures of your prostate and can help your healthcare team spot signs of cancer early.
MRI can also be used during a procedure called an MRI-guided prostate biopsy. In these procedures, a special type of MRI with higher sensitivity, called a multiparametric MRI (mpMRI), helps doctors find areas that may need to be sampled for cancer.
MRI results can help doctors decide if a biopsy is needed and guide exactly where to take tissue samples from the prostate. MRI also provides valuable details for determining the stage of prostate cancer, which is important for planning treatment and next steps.
A doctor will review your MRI results and may assign a score using a system such as the Likert scale, which rates the chance that cancer is present from 1 (very unlikely) to 5 (very likely).
It’s important to remember that this rating shows only the level of suspicion based on the scan, not a diagnosis. The decision to recommend a biopsy depends on this score, your other health conditions, and the size of your prostate. A biopsy is the only way to diagnose prostate cancer if it is present.
Ultrasound uses sound waves that bounce off tissues inside your body. These waves return signals to the probe, which are then turned into pictures of the targeted area.
For prostate cancer, ultrasound imaging is typically transrectal, meaning the probe goes into the rectum to get a clear image of the prostate.
Ultrasound imaging helps doctors get a closer look at the prostate. Your doctor may recommend an ultrasound if they notice something unusual during a DRE or if your PSA test shows abnormal results.
Ultrasound can be used alone or along with MRI during a biopsy procedure. It provides real-time images on a screen, so doctors can see exactly where the biopsy needle is and guide it to the right spot.
Ultrasound images, called sonograms, help your healthcare team see any areas of the prostate that look suspicious. Because ultrasound gives a live image, doctors can move the probe to get different views and make sure they are targeting the right area, especially during a biopsy.
A PET/CT scan combines two imaging techniques, positron emission tomography (PET) and computed tomography (CT), to give doctors a clearer and more detailed view of your body.
The PET scan detects areas where the tracer builds up, which may show fast-growing cells, such as cancer. The CT scan takes detailed X-ray images of the structures in your body. When these two scans are combined, doctors can see both where the tracer is located and exactly what part of the body it’s in. This combination is much more helpful than PET alone, since CT provides the anatomical detail needed to accurately pinpoint any suspicious spots.
Doctors may use a PET/CT scan after prostate cancer has been diagnosed with a biopsy. PET/CT scans can help stage the cancer (find out how far it has spread) and check if it has moved to other parts of the body, such as lymph nodes, bones, or organs.
There is a special type of PET/CT scan called a prostate-specific membrane antigen (PSMA) PET/CT scan. For this test, a small amount of radioactive tracer is injected into a vein. The tracer attaches to a protein (PSMA) found on many prostate cancer cells, which can help cancer show up on the scan. A PSMA PET/CT scan can help doctors find prostate cancer that has spread or come back after treatment. It is especially helpful for spotting small areas of cancer in or around the prostate or elsewhere in the body, such as in lymph nodes or bones.
In addition to the scans mentioned above, other scans can be helpful with prostate cancer imaging. Your doctor might also order bone scans and CT scans.
Bone scans are exactly what they sound like: images that show your bones. Similar to PET scans, they are another type of nuclear test. You’ll get a small amount of radioactive tracer injected into your bloodstream before the scan. The tracer will attach to cells that are growing quickly.
A bone scan can show if there are areas of bone that absorbed the tracer. Bone scans can be used after a biopsy to determine if the cancer has spread to your bones.
As noted, CT scans use X-ray technology to create cross-sectional images of the body. They’re often used after a biopsy to see if the cancer has spread. They can show more detailed imaging of lymph nodes, blood vessels, organs, and soft tissues. Sometimes, a CT scan is performed on its own, but as discussed above, it’s more often combined with a PET scan (as a PET/CT).
On MyProstateCancerTeam, people share their experiences with prostate cancer, get advice, and find support from others who understand.
Have you experienced any of the scans above regarding your prostate cancer? Let others know in the comments below.
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