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Standardisation of prostate multiparametric MRI across a hospital network: a London experience

Published version
Peer-reviewed

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Type

Article

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Authors

Papoutsaki, Marianthi-Vasiliki 
Allen, Clare 
Giganti, Francesco 
Atkinson, David 
Dickinson, Louise 

Abstract

Abstract: Objectives: National guidelines recommend prostate multiparametric (mp) MRI in men with suspected prostate cancer before biopsy. In this study, we explore prostate mpMRI protocols across 14 London hospitals and determine whether standardisation improves diagnostic quality. Methods: An MRI physicist facilitated mpMRI set-up across several regional hospitals, working together with experienced uroradiologists who judged diagnostic quality. Radiologists from the 14 hospitals participated in the assessment and optimisation of prostate mpMRI image quality, assessed according to both PiRADSv2 recommendations and on the ability to “rule in” and/or “rule out” prostate cancer. Image quality and sequence parameters of representative mpMRI scans were evaluated across 23 MR scanners. Optimisation visits were performed to improve image quality, and 2 radiologists scored the image quality pre- and post-optimisation. Results: 20/23 mpMRI protocols, consisting of 111 sequences, were optimised by modifying their sequence parameters. Pre-optimisation, only 15% of T2W images were non-diagnostic, whereas 40% of ADC maps, 50% of high b-value DWI and 41% of DCE-MRI were considered non-diagnostic. Post-optimisation, the scores were increased with 80% of ADC maps, 74% of high b-value DWI and 88% of DCE-MRI to be partially or fully diagnostic. T2W sequences were not optimised, due to their higher baseline quality scores. Conclusions: Targeted intervention at a regional level can improve the diagnostic quality of prostate mpMRI protocols, with implications for improving prostate cancer detection rates and targeted biopsies.

Description

Funder: North East London Cancer Alliance


Funder: KCL/UCL Comprehensive Cancer Imaging Centre


Funder: UCLH Biomedical Research Centre

Keywords

Original Article, Multiparametric magnetic resonance imaging, Clinical protocols, Prostatic neoplasms, Diffusion, Contrast media

Journal Title

Insights into Imaging

Conference Name

Journal ISSN

1869-4101

Volume Title

12

Publisher

Springer International Publishing