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Prostate Magnetic Resonance Spectroscopic Imaging
Prostate Magnetic Resonance Spectroscopic Imaging (MRSI) is used to examine the prostate to distinguish between normal tissue, tumours, infection, and other abnormalities as well as assess changes following treatment.
The prostate is a small gland that is part of the male reproductive system. It is located below the bladder, where urine is stored, and surrounds the urethra, the tube that carries the urine and other fluids out of the body. The prostate helps make the milky fluid, called semen, that carries sperm. Magnetic Resonance Imaging uses the changes in the behaviour of atomic particles when they are exposed to radio waves in the presence of a strong magnetic field to create an image of the prostate gland. Magnetic resonance measures the relaxation times of hydrogen protons after they have been excited by radio waves. Differences in hydrogen content between healthy and diseased tissue allows the visualization of abnormalities. MRSI provides additional information about the chemicals present in the cells.
This test is not covered by OHIP, so it is necessary to be prepared to pay for this test. Cash, debit and credit cards are all accepted methods of payment.
You should eat light meals on the day prior to the test and have only clear fluids on the day of the test. DO NOT drink coffee, milk, cream, or tea on the day of the test
You must use a fleet enema preparation 3 hours prior to the test on the day of your examination to help clear your bowels to ensure a better image during the test.
Bring a list of all present medications.
You will not be able to wear jewelry, dental work or other metallic accessories during the procedure.
Please plan to arrive a half hour before your appointment to get ready for the test.
Prior to the test, you will be asked to verify the patient screening questionnaire. Please read the questions carefully and verify the answers to the best of your knowledge.
It is very important for you to inform the technologist conducting the test if you are claustrophobic and/or have metal implants, joint replacements or a pacemaker.
If you have any questions about the screening questionnaire or the test, do not hesitate to ask the technologist. He or she will explain the entire procedure before it begins.
You will then be asked to change into a gown and remove any metallic items you may have. The technologist will then take you into the MRI room and will help you onto the imaging table.
The MRI examination will involve the use of a double-walled latex balloon endorectal probe. The probe, lubricated with Xylocaine jelly, is inserted into your rectum and positioned under your prostate. After the probe is placed inside the rectum, the balloon is inflated with a liquid called Fluorinert, to hold the coil in place during the test. You will feel a small amount of pressure in your rectum similar to that experienced during a rectal test. Once the test is completed, the probe is removed. During the exam, you may feel slightly warm in the pelvic area.
The technologist will position you in the MRI machine and leave the room to start the imaging process. The technologist will have you in full view at all times during the test and will be in constant communications with you via two-way microphones. It may take up to 60 minutes to take the pictures and it is important to lie as still as possible when the pictures are being taken to avoid blurring the images.
A written report will be sent to your physician upon completion of the test. Your physician will then explain the test results to you.
The test lasts approximately 90 minutes.
You will feel a small amount of pressure in your rectum when the probe is inserted. You may also feel warming in the pelvic area. You might hear the hum of the equipment as the images are being taken.
There is a remote risk (<1%) that the liquid, Fluorinert, used to inflate the balloon, could leak out of the balloon. The balloon is designed to prevent this from happening and an additional precaution of performing an inflation check is done prior to the insertion. If the leak does occur, a tap water enema will be performed to clean the rectal area.
There is a remote risk (<1%) that your rectum could be perforated by the probe.
If you have had rectal surgery, radical prostatectomy, hip replacement, have anal fissures, inflammatory bowel disease or a known allergy to latex compounds and/or Xylocaine, the MRSI may be inappropriate for you.