Traditionally people who have been referred with a raised PSA come in for a standard clinic appointment where they have a rectal examination and then we book them for a rectal biopsy. There are several problems with this, firstly they are random biopsies, secondly there is a higher risk of sepsis, and thirdly you are not getting all the information. These days especially at Manchester Urology we can offer MRI scanning before a biopsy. We have access to lots of MRI scanners and also Uroradiologists who are trained specifically to report MRI scans. We offer 3 Tesla MRI and also Multiparametric MRI which are words that are thrown around a lot but we do have access and offer these routinely. The benefit of having an MRI before biopsy is that we can look at PSA Density and then look at the MRI itself to see if there are any abnormal areas. There are lots of different scoring systems to look at abnormal areas within a prostate but when you pull it all together, when you look at the history, the clinical examination, the PSA the MRI scan, the scoring system such as the PIRADS scoring system or the LIKERT scoring system on the prostate you can pull it together and often if everything is favourable you may even not need a biopsy anymore. If you do need a biopsy you know that you definitely need a biopsy and we can offer MRI fusion transperineal targeted biopsies of any abnormal areas, and then transperineal mapping biopsies if you need any other areas sampled. So we can offer the full range of treatments and investigations for a patient referred with a raised PSA.