MRI Pelvis & Abdomen

MRI

Varies

OutpatientInpatient

All imaging requests must be justified by an IR(ME)R practitioner (radiologist or radiographer)

Prostate cancer mpMRI (NG131)

mpMRI as first-line investigation; biopsy decision based on Likert score

— ALL of the following must be met

— ANY of the following

TVS first-line; MRI for deep endometriosis; normal imaging does NOT exclude diagnosis

TVS first-lineNICE NG73 Rec 1.5.2
Pelvic MRI for deep endometriosis assessmentNICE NG73 Rec 1.5.9
Normal USS/MRI does NOT exclude endometriosis — consider laparoscopyNICE NG73 Rec 1.5.12

— ANY of the following

MRI enterography preferred over CT (no radiation — critical for young patients)NICE NG129
METRIC trial sensitivity 96% for small bowel disease
NOTE: NG129 does NOT contain specific MRI recommendations — guideline gap

CT is primary staging modality; MRI NOT routinely recommended for suspected ovarian cancer

If USS/CA125 suggest ovarian cancer → CT pelvis and abdomenNICE CG122 Rec 1.2.3.2
Do NOT use MRI routinely for suspected ovarian cancerNICE CG122 Rec 1.2.3.3

Information

mpMRI is first-line for suspected prostate cancer

NICE NG131

Information

MRI enterography preferred over CT for Crohn's

Warning

Normal USS/MRI does NOT exclude endometriosis

NICE NG73

Information

NG129 has no specific MRI recommendations — BSG/ECCO guidelines apply

Pregnancy

MRI pelvis can be performed in pregnancy. Gadolinium contraindicated except when essential. TVS remains first-line for pelvic pathology in pregnancy.

NG155 → CG122 (2011)

References to 'NG155' for ovarian cancer are incorrect — correct guideline is CG122

v2.02026-03-08New protocol — MRI pelvis and abdomen indications (prostate, rectal, cervical, endometriosis, Crohn's, ovarian)