Diagnosis and Evaluation

What are some other prostate cancer evaluation procedures? If the DRE or PSA is unusual, your doctor may repeat the tests or request an ultrasound and other procedures. These evaluation tools may include:

Prostate Biopsy

A test in which the doctor inserts thin, hollow needles into the prostate to get samples for examination under a microscope to determine if cancer cells are present.

Transrectal Ultrasound (TRUS)

A test using sound wave echoes to create an image of the prostate gland to visually inspect for abnormal conditions, such as gland enlargement, nodules, penetration of tumor through the outer capsule of the gland, and/or invasion of seminal vesicles; may also be used for guidance of needle biopsies of the prostate gland and/or guiding the nitrogen probes in cryosurgery.

Computed Tomography Scan (CT/CAT Scan)

A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

Magnetic Resonance Imaging (MRI)

MRI’s use a strong magnetic field rather than x-rays to produce images. MRI gives a very clear picture of soft-tissue structures near and around bones, and it is the most sensitive exam for spinal and joint problems.

MRI produces images by focusing radiofrequency waves at protons (in the nuclei of hydrogen atoms) in a strong magnetic field. The protons are “excited” then “relaxed,” causing them to emit radio signals, which are recorded and processed to create an image. MRI images show the subtle differences in the tissues of the body, even the different types of tissue within the same organ.

Because the MRI scanner uses a magnetic field to produce images, certain types of metals cannot enter the scanning room. To ensure the safety of patients and technologists, a metal screening form needs to be completed prior to the exam. This form will be completed during the scheduling process, then reviewed by the technologists upon patient arrival. There are no preparations for an MRI scan.

Radionuclide Bone Scan

A nuclear imaging method that helps to show whether the cancer has spread from the prostate gland to the bones. The procedure involves an injection of radioactive material that helps to locate diseased bone cells throughout the entire body, suggesting possible metastatic cancer.

Lymph Node Biopsy

A procedure in which tissue samples are removed (with a needle or during surgery) from the lymph nodes near the prostate for examination under a microscope to determine if cancer or other abnormal cells are present. The diagnosis of cancer is confirmed only by a biopsy.