MRI-guided prostate biopsy in a patient post colectomy

While multiparametric prostate MRI is not currently used as a first-line tool for diagnosing prostate cancer, it has proven very helpful for directing targeted biopsies, particularly in select men like our patient with persistent, elevated PSA levels, and a previous negative transrectal ultrasound-guided biopsy.1 Yacoub et al concluded that the information gleaned from prostate MRI for direct targeting of lesions for biopsy may help increase diagnostic yield, improve accuracy of identification and characterization of prostate cancers, and assist in patient selection for specific therapies.2 IMAGING FINDINGS Multiparametric MR imaging was performed to acquire high-resolution images through the prostate gland and seminal vesicles. Recent literature and experience have proven its value for cancer diagnosis, grading and staging when used to target specific areas of the prostate gland for biopsy.2 In the unusual clinical scenario of the patient presenting post- abdomino-perineal resection (APR), MRI-guidance may be used when insertion depth is adequate, providing more control and less radiation than transgluteal computed tomography (CT) guided prostate biopsy.