Prostate MRI Follow-Up: Why Radiologists Compare Your Previous Scans
Leer en español: Resonancia de próstata: por qué importan tus estudios previos.
It's Movember, the month many men grow a moustache and, more usefully, finally book the check-up they have been putting off. If you are one of the many men who have had more than one prostate MRI, this post is about one practical thing: making sure every earlier MRI reaches the radiologist reading your next one.
Why a prostate MRI follow-up is a comparison
Men often have a prostate MRI more than once: after a raised PSA test, before or after a biopsy, on a monitoring plan such as active surveillance, or after treatment. Each time, the radiologist is answering two questions:
- What does the prostate look like today?
- What has changed since the last MRI?
The second question needs the earlier images. A spot that looks the same as two years ago, one that has grown, and one that is new tell three very different stories, and only side-by-side images can show which one you have.
This comparison matters enough that a European expert panel published recommendations, called PRECISE (Prostate Cancer Radiological Estimation of Change in Sequential Evaluation), on how radiologists should report change across a series of prostate MRIs in men on active surveillance (Moore et al., European Urology, 2017). The whole idea assumes one thing: that the earlier scans are available.
What any change means for you is a conversation for your urologist and your radiologist. This post only helps you get the images to them.
Where your earlier prostate MRIs usually are
If your scans were all done at one hospital, the radiologist may already have them. But many men move between a local imaging center, a hospital for the biopsy, and a specialist center for a second opinion. Earlier MRIs may be:
- On CDs or DVDs you received after each scan.
- In another facility's archive, which you can ask them to copy for you. Ask for the images, not only the written report.
- On a USB drive or download link, which some centers now provide.
Ask early. Copies can take days, so request them a week or two before your appointment.
Step 1: Check what is on each disc
You don't need to look at the images. You just need to confirm the files are there.
- On a Mac: insert the disc (many Macs need an external USB disc drive). It appears on the desktop or in the Finder sidebar. Double-click it to open it as a folder, and ignore any program that tries to start.
- On Windows: insert the disc. If a window asks what to do, choose Open folder to view files. If nothing happens, open File Explorer and click the disc drive (often D: or E:).
Look for a file called DICOMDIR or a folder named DICOM or IMAGES. If you see them, your MRI is there, even if the viewer on the disc won't start. (What to do when a hospital CD won't open on a Mac.)
Step 2: Put every MRI on one USB
Several discs from several places means the new center has to load each one separately, and some may not load at all. One organized USB is easier for everyone.
MIA Toolkit is a free desktop app for Mac and Windows. You insert your discs one by one; it copies the studies onto your computer, gives you a plain inventory of what each disc contained, and writes everything to one USB drive with a standard index (DICOMDIR) that imaging systems are designed to open. You can add your biopsy and radiology reports to the same drive, so the images and the words travel together. (How to share that USB with your doctor.)
What to bring to the appointment
- The USB with your earlier MRIs, plus the original discs as a backup.
- Your radiology and biopsy reports.
- A short list of past scans and tests with dates and places, so nobody has to guess what is missing.
Mention at check-in that you brought previous MRIs, so they can be loaded before the radiologist reads your new one. If the center prefers to request them directly from the other facility, follow their process.
Your images stay private
MIA Toolkit works offline: no account, no cloud upload, no tracking. Your scans never leave your computer; you are copying your own files onto a USB you control. It is free, and it always will be.
What this tool is, and what it is not
MIA Toolkit is a file-management tool: it copies, organizes and converts your imaging studies so you can carry them. It does not read or interpret images, and it does not replace your radiologist, your urologist or your doctor. It comes with no warranty. If you have questions about your PSA, your MRI results or your follow-up plan, talk to your doctor.
When you are ready, you can download MIA Toolkit for free, with a step-by-step guide and screenshots. More patient guides are on the patients page, including why you should bring prior mammograms for the same reason. Questions: support@miatools.tech.
Sources
- Moore CM, et al. Reporting magnetic resonance imaging in men on active surveillance for prostate cancer: the PRECISE recommendations. European Urology, 2017. PubMed 27349615.
FAQ
Why does my radiologist want my previous prostate MRI? Because a prostate MRI follow-up is a comparison. The radiologist looks at what the prostate looks like today and at what has changed since earlier scans. That second part needs the earlier images.
Is the written report from my last MRI enough? Ask your center, but the images are usually what makes a side-by-side comparison possible. When you request copies, ask for the images as well as the report.
My old MRI disc won't open. Is it broken? Often not. The viewer program on the disc is what usually fails, not the images. Open the disc as a folder and look for a DICOMDIR file. MIA Toolkit can copy the studies onto one USB.
Is it safe to keep my scans on a USB? MIA Toolkit runs offline, with no account and no cloud, so the images stay on your computer and the USB you create. Keep the USB somewhere safe, as you would any medical record.