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Published on: April 9, 2019
Imaging quality and prostate MR: it is time to improve
Francesco Giganti1,2, Clare Allen1
1Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK.
Abstract:
The Prostate Imaging Reporting and Data System (PI-RADS) guidelines set out the minimal technical requirements for the acquisition of multiparametric MRI (mpMRI) of the prostate. However, the rapid diffusion of this technique has inevitably led to variability in scan quality among centres across the UK and the world. Suboptimal image acquisition reduces the sensitivity and specificity of this technique for the detection of clinically significant prostate cancer and results in clinicians losing confidence in the technique.Two expert panels, one from the UK and one from the European Society of Urogenital Radiology (ESUR)/EAU Section of Urologic Imaging (ESUI), have stressed the importance to establish quality criteria for the acquisition of mpMRI of the prostate. A first attempt to address this issue has been the publication of the Prostate Imaging Quality (PI-QUAL) score, which assesses the mpMRI quality against a set of objective criteria (PI-RADS guidelines) together with criteria obtained from the image.PI-QUAL represents the first step towards the standardisation of a scoring system to assess the quality of prostate mpMRI prior to reporting and allows clinicians to have more confidence in using the scan to determine patient care. Further refinements after robust consensus among experts at an international level need to be agreed before its widespread adoption in the clinical setting.
Insights
The Prostate Imaging Quality (PI-QUAL) score was developed to standardize prostate multiparametric MRI (mpMRI) quality. This tool aims to improve diagnostic accuracy for prostate cancer detection and clinician confidence in mpMRI scans.
Area of Science:
- Radiology
- Medical Imaging
- Urologic Oncology
Background:
- Prostate Imaging Reporting and Data System (PI-RADS) guidelines specify minimal technical requirements for prostate multiparametric MRI (mpMRI).
- Variability in mpMRI scan quality exists globally, impacting the sensitivity and specificity for detecting clinically significant prostate cancer.
- Clinicians' confidence in mpMRI for patient care is reduced by suboptimal image acquisition.
Purpose of the Study:
- To address the need for standardized quality criteria in prostate mpMRI acquisition.
- To introduce the Prostate Imaging Quality (PI-QUAL) score as a tool for assessing mpMRI quality.
- To enhance clinician confidence in utilizing mpMRI for prostate cancer management.
Main Methods:
- Development of the Prostate Imaging Quality (PI-QUAL) score.
- Assessment of mpMRI quality against objective PI-RADS criteria and image-derived criteria.
- Expert panel review and consensus building.
Main Results:
- The PI-QUAL score is the first system to assess prostate mpMRI quality before reporting.
- It provides a standardized method to evaluate image acquisition against established guidelines.
- The score aims to increase trust in mpMRI findings for clinical decision-making.
Conclusions:
- The PI-QUAL score represents a significant step towards standardizing prostate mpMRI quality assessment.
- Further international expert consensus is required for widespread clinical adoption.
- Standardized quality assessment will improve the reliability and utility of mpMRI in prostate cancer care.
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