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Use of MRI-ultrasound Fusion to Achieve Targeted Prostate Biopsy
Published on: April 9, 2019
A critical analysis of deficiencies in the quality of information contained in prostate multiparametric MRI requests
Orla Cullivan1, Emma Roche2, Mohammad Hegazy2
1Department of Urology, Galway University Hospital, Galway, Ireland. orla.cullivan@hse.ie.
Background:
Multiparametric magnetic resonance imaging (mpMRI) has been increasingly recognised as an important tool in the diagnosis of prostate cancer. PI-RADSv2 guidelines recommend that important clinical information including prostate-specific antigen (PSA) levels, examination findings, and biopsy information should be included in mpMRI requests. PIRADS score and PSA density (PSAD) are both independent predictors for the presence of a clinically significant prostate cancer.
Aims:
This study aims to evaluate the quality of mpMRI requests and reports at our institution in accordance with these parameters.
Methods:
All prostate mpMRIs performed by radiology services in Galway University Hospital between 1st September 2019 and 1st March 2020 were reviewed. Exclusion criteria were applied. Requests and reports were analysed for the presence of the following parameters: PSA-results, examination findings, biopsy information, PI-RADS score, prostate volume, and PSAD.
Results:
A total of 586 mpMRIs were performed, and of these, 546 were included. PSA value was provided in 497 (91%) of requests, exam findings in 355 (65%), and biopsy information in 452 (82%). PIRADS score was included in 224 (41%) of reports, prostate volume in 178 (32.6%), and PSAD in 106 (19%).
Conclusions:
Great variation in the quality of information contained in both requests and reports for prostate mpMRIs exists within our service. We aim to improve this by collaborating with our radiology colleagues to develop a proforma for requesting and reporting of mpMRIs for our radiology systems to ensure important clinical and radiological information is provided in future.
Insights
Quality of prostate cancer multiparametric MRI (mpMRI) requests and reports varies significantly. This study highlights the need for standardized reporting to ensure crucial clinical information is consistently included for accurate prostate cancer diagnosis.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Multiparametric magnetic resonance imaging (mpMRI) is vital for prostate cancer diagnosis.
- PI-RADSv2 guidelines emphasize including clinical data like PSA levels, exam findings, and biopsy results in mpMRI requests.
- PI-RADS score and PSA density (PSAD) are key predictors of clinically significant prostate cancer.
Purpose of the Study:
- To assess the quality of prostate mpMRI requests and reports at Galway University Hospital.
- To evaluate the adherence to PI-RADSv2 guidelines regarding essential clinical information in mpMRI requests and reports.
Main Methods:
- Reviewed 546 prostate mpMRIs performed between September 2019 and March 2020.
- Analyzed requests and reports for the presence of PSA results, examination findings, biopsy information, PI-RADS score, prostate volume, and PSAD.
Main Results:
- PSA values were present in 91% of requests, exam findings in 65%, and biopsy information in 82%.
- PI-RADS score was reported in 41% of cases, prostate volume in 32.6%, and PSAD in only 19%.
Conclusions:
- Significant variability exists in the quality of information within prostate mpMRI requests and reports.
- A standardized proforma is proposed to improve the consistency and completeness of clinical and radiological information in future mpMRI requests and reports.
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Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...