Purpose Standard radiology reports (SRR) are designed to communicate information between doctors. With many patients having instantaneous access to SRRs on patient portals, interpretation without guidance from doctors can cause anxiety and panic. In this pilot study, we designed a patient-centred prostate MRI template report (PACERR) to address some of these challenges and tested whether PACERRs improve patient knowledge and experience. Materials and methods Patients booked for clinical prostate MRI were randomly assigned to SRR or SRR + PACERR. Questionnaires included multiple-choice that targeted 4 domains (understanding, usefulness, next steps, emotional experience) hypothesized to improve with patient-centred reports and short answer questions, testing knowledge regarding MRI results. Clinical encounters were observed and recorded to explore whether adding PACERR improved communication. Likert scaled-responses and short-answer questions were compared using Mann-Whitney U test and Kruskal-Wallis test. Results Of the 40 participants, the majority were MRI naïve (70%). Patients receiving a PACERR had higher scores in the categories of patient understanding (mean: 4.17 vs. 3.39, p =0.006), usefulness (mean: 4.58 vs. 3.07, p <0.001), and identifying next steps (mean: 1.89 vs. 3.03, p =0.003) but not emotional experience (mean: 4.18 vs. 3.79, p =0.22). PACERR participants found the layout and design more patient friendly (mean: 4.47 vs. 2.61, p <0.001) and easier to understand (mean: 4.37 vs. 2.38, p <0.001). In the knowledge section, overall, the PACERR arm scored better (87% vs. 56%, p =0.004). Conclusion With the addition of prostate MRI PACERR, participants had better understanding of their results and felt more prepared to involve themselves in discussions with their doctor.