How to Read Your Prostate MRI Report
MRI of the prostate is primarily used to evaluate prostate cancer. Your doctor will use this exam to:
- detect suspected prostate cancer
- measure the size of cancer (local staging)
- see if cancer has spread (metastasized)
- monitor any changes
- assess the effectiveness of treatment
- look for any treatment complications
- see if cancer has returned.
Occasionally, prostate MRI may be used to detect:
- infection (prostatitis)
- enlarged prostate or benign prostatic hyperplasia (BPH)
- abnormalities present from birth
- complications after pelvic surgery
A radiologist views the images, offers a diagnosis, and gives your doctor a report of the findings. Your doctor will share the results with you. Many patients can also see their radiology reports and medical images through online patient portals and electronic health records.
About Your Report
The report is written for your doctor. So, it contains medical terms you may find hard to understand. The report commonly includes six sections:
Type of exam
The section lists the date, time and type of exam performed.
This section lists:
- your age, gender and health information, including symptoms
- the reason for the exam
- your diagnosis (if there is one) or suspected diagnosis.
If the radiologist compared this exam with previous exams, those are listed here.
This section lists the images taken during your exam. It also includes details about how the exam was done. You will see technical information. This may include any special techniques used to measure water molecule motion (water diffusion) and blood flow (perfusion imaging) within the prostate.
This section lists the radiologist's important observations. Details of suspicious findings are listed here, including:
- the size and location of abnormalities (also called lesions)
- the likelihood that an abnormality is a significant prostate cancer using the PI-RADS system (see table below)
- whether or not the cancer has spread (called staging)
- incidental findings.
Prostate Imaging Reporting and Data System (PI-RADS)
Radiologists use the Prostate Imaging Reporting and Data System (PI-RADS) to report how likely it is that a suspicious area is a clinically significant cancer. PI-RADS scores range from 1 (most likely not cancer) to 5 (very suspicious). The five scores include:
- PI-RADS 1: Very low
- PI-RADS 2: Low
- PI-RADS 3: Intermediate (undetermined)
- PI-RADS 4: High
- PI-RADS 5: Very High
While looking at your images, the radiologist may see abnormalities outside the prostate. These are called incidental findings because they were not the reason the exam was ordered.
Impression (or Conclusion)
In this section, the radiologist gives a diagnosis based on the findings, your medical history and the reason for the exam. This is the most important part of the report.
You and your doctor will use your report to make decisions about your care. If you have questions your doctor cannot answer, talk to the staff at your imaging facility. Many radiologists are happy to talk with you and answer any questions.
This page was reviewed on May 01, 2023