Your Certified Specialist at the Alte Saline Radiology Center
Dr. med. Philip Alexander Glemser
He is a board-certified specialist in both radiology and nuclear medicine and your certified expert in prostate MRI in Bad Reichenhall and the Berchtesgadener Land region. Close interdisciplinary collaboration with his colleagues in urology is particularly important to him.
As part of his long-standing medical and scientific work at the German Cancer Research Center in Heidelberg, he has been focusing on MRI imaging of the prostate for many years. He has been awarded the highest “Q2 Prostatography Certificate” from the German Radiological Society for prostate MRI. His research on prostate MRI, as both lead and co-author, has been published in numerous peer-reviewed journals.
What are the benefits of prostate MRI diagnostics at our facility, the Alte Saline?
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State-of-the-art 3-Tesla MRI Diagnostics
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Optimized MRI Examination Protocol adapted by MRI physicists at the German Cancer Research Center in Heidelberg
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Interpretation by certified experts from the German Radiological Society (Q2)
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Standardized Evaluation According to PI-RADS
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Close interdisciplinary collaboration with our urologists
Why do we rely on prostate MRI at the Alte Saline?
Prostate MRI is a gentle, non-invasive, radiation-free procedure that provides highly precise imaging of the prostate. Pioneering, large-scale studies such as the PROMIS (1), PRECISION (2), and MRI-FIRST (3) studies have shown:
- Prostate MRI reliably detects clinically significant prostate cancers
- Unremarkable MRI scans can help avoid unnecessary biopsies
- MRI-guided biopsies (when necessary) result in greater diagnostic accuracy than conventional standard procedures
References:
- El-Shater Bosaily A, Parker C, Brown LC, Gabe R, Hindley RG, Kaplan R, et al. PROMIS–Prostate MR imaging study: A paired validating cohort study evaluating the role of multi-parametric MRI in men with clinical suspicion of prostate cancer. Contemp Clin Trials. 2015;42:26-40.
- Kasivisvanathan V, Rannikko AS, Borghi M, Panebianco V, Mynderse LA, Vaarala MH, et al. MRI-Targeted or Standard Biopsy for Prostate-Cancer Diagnosis. N Engl J Med. 2018;378(19):1767-77.
- Rouvière O, Puech P, Renard-Penna R, Claudon M, Roy C, Mège-Lechevallier F, et al. Use of prostate systematic and targeted biopsy on the basis of multiparametric MRI in biopsy-naive patients (MRI-FIRST): a prospective, multicentre, paired diagnostic study. Lancet Oncol. 2019;20(1):100-9.
When should a prostate MRI be performed?
- Evaluation of an Elevated PSA Level: When PSA levels in the blood are elevated (PSA = prostate-specific antigen), an MRI is used to distinguish between benign changes, such as benign prostatic hyperplasia (BPH), and possible malignant changes suggestive of a tumor.
- Evaluation of an abnormal finding detected during a digital rectal exam (e.g., an unexplained hardening of the prostate).
- Treatment Monitoring and Follow-Up Care: After surgery or radiation therapy, MRI is used to assess the effectiveness of treatment and to detect potential relapses—known as recurrences—at an early stage.
- Active Surveillance: Follow-up MRI scans for clinically insignificant, low-grade tumors that have not undergone initial treatment.
Is it possible to avoid a biopsy by having a prostate MRI?
Prostate MRI not only enables the detection of aggressive prostate tumors but is also highly reliable in ruling out a clinically significant tumor in cases where the examination is unremarkable. Radiological and technical advances in recent years, along with the establishment of multiparametric prostate MRI as the standard procedure for prostate evaluation, have also led to changes in the “S3 Guidelines for Prostate Cancer.” This guideline is developed by professional societies such as the German Society of Urology and the German Oncology Guidelines Program, and serves as a medical recommendation for the diagnosis, treatment, and follow-up care of prostate cancer. In its current version (2025), an MRI of the prostate is recommended prior to a biopsy and when the PSA level is 3 ng/mL or higher, or in the event of a significant rise in PSA levels.
If this prostate MRI is normal or shows only benign changes in the prostate, a biopsy—which is invasive for the patient—can generally be avoided.
If, on the other hand, a lesion suspected of being a tumor is detected on a radiological examination, a targeted biopsy of that lesion can be performed with even greater precision and is often supplemented by a systematic prostate biopsy, in which all zones of the prostate are examined by taking additional tissue samples as part of the biopsy.
Example 1: In this case, a highly suspicious lesion (yellow arrow) was identified via prostate MRI; the subsequent biopsy revealed highly aggressive prostate cancer. The patient was thus able to receive appropriate treatment in a timely manner.
Example 2: In this case, the prostate MRI ruled out a lesion suspected of being a tumor; the findings indicated benign prostate enlargement. An invasive biopsy was not necessary.
What You Should Know About Prostate MRIs!
mpMRI stands for multiparametric magnetic resonance imaging, in which multiple MRI sequences or image series are acquired to visualize various tissue characteristics of the prostate (anatomy, cell density, and contrast agent behavior). The findings are then interpreted based on the internationally recognized PI-RADS reporting standard (PI-RADS = Prostate Imaging Reporting and Data System).
An MRI scan of the prostate usually takes about 30 minutes.
No, the MRI scan is painless. As with any MRI scan, the strong magnetic fields produce loud knocking noises that some patients find unpleasant, so you will be given noise-canceling headphones to wear.
To ensure we can examine you as thoroughly as possible, we will ask you relevant questions using a questionnaire that we have developed specifically for prostate MRI examinations (including, among other things):
- PSA level and PSA trend
- Previous biopsies and biopsy results?
- Known prostate cancer?
- Regular medication use
- Pre-existing medical conditions?
- Can you take Buscopan? We often use this medication to reduce bowel movements and thereby further improve image quality. However, in certain cases, this medication may not be suitable for you (e.g., glaucoma, angle-closure glaucoma, severe cardiac arrhythmias, etc.).
- Do you have any metal implants in your body?
- Do you suffer from claustrophobia?
- Do you have any known allergies?
- Do you take any medications regularly?
- Do you have any pre-existing medical conditions?
Private health insurance companies usually cover the costs of a multiparametric MRI of the prostate without any issues. With public health insurance plans, there are generally no options for separate billing. An application for BDR (Professional Association of German Radiologists) certification for selective billing of multiparametric MRI of the prostate at the Alte Saline has been submitted and is currently in the approval process.
If you have any questions regarding prostate MRI exams, Dr. Philip Alexander Glemser will be happy to assist you. You are also welcome to send your questions to prostata@radiag.de.