The title is a bit of a trick question. MRI can’t “see” actual genes or prostate cancer gene mutations. There are indeed genetic factors that contribute to both the risk of developing prostate cancer (PCa), and the behavior of particular cell lines. Ongoing research continues to shed light on the genomics of prostate cancer, and there are already numerous, commercially available products that analyze for specific genomic biomarkers.

We have known for many years that a family history of PCa raises the odds that a man will develop the disease. Having a father or brother with PCa is a major risk factor, and most men today know that PCa gene mutations, as with some other cancers, can be inherited.

However, many men are not aware that a family history of breast cancer (particularly mother or sister) may mean that a male relative is carrying a gene mutation called BRCA. When a man is diagnosed with PCa, if he indicates that he has a first-degree female relative with breast cancer, or BCa, his doctor will order a genomic analysis for the presence of any BRCA biomarker. Research studies have found a link between BRCA and more aggressive PCa cell lines. If this is the case, the patient is said to have BRCA associated prostate cancer. This entails greater likelihood that at the time of diagnosis, his cancer may already have spread to nearby lymph nodes, or even more distant locations, so it’s essential to identify BRCA-associated PCa as early as possible.

MRI may detect BRCA-associated PCa

To return to the question of whether MRI can actually “see” BRCA-linked PCa, it can’t depict the individual cells or their genes, but it can distinguish tumor features that point to the need for immediate genomic analysis. News of this ability was recently published by an interdisciplinary team from Oregon Health & Science University. They report on four patients whose multiparametric MRI (mpMRI) revealed characteristics of BRCA-associated PCa, being “generally locally advanced and aggressive in appearance.”^[i] In describing the imaging characteristics they found, the authors also underscore the importance of immediate genetic testing and counseling. In a very real way, they are not treating just the individual patient, but his siblings, sons and even daughters, who may also be carrying the PCa and BCa vulnerability.

In this sense, MRI is like a first alert that “sees” and presents real evidence to a knowledgeable radiologic interpreter of the presence of a dangerous threat. The sooner the danger is known, the more opportunity there is to target a biopsy so the cellular genomics can be analyzed. In turn, this greatly increases the potential for successful treatment, and for advising family members to diligently screen for BRCA-associated cancers.

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

[i] Kamal O, Foster BR, Young DJ, Hansel DE, Coakley FV. MRI appearance of BRCA-associated prostate cancer. Clin Imaging. 2022 Apr;84:135-139.