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Quality of prostate MRI in early diagnosis-a national survey and reading evaluation
Linda C P Thijssen1, Jasper J Twilt2, Tristan Barrett3
1Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands. linda.thijssen@radboudumc.nl.
Objectives:
The reliability of image-based recommendations in the prostate cancer pathway is partially dependent on prostate MRI image quality. We evaluated the current compliance with PI-RADSv2.1 technical recommendations and the prostate MRI image quality in the Netherlands. To aid image quality improvement, we identified factors that possibly influence image quality.
Materials And Methods:
A survey was sent to 68 Dutch medical centres to acquire information on prostate MRI acquisition. The responding medical centres were requested to provide anonymised prostate MRI examinations of biopsy-naive men suspected of prostate cancer. The images were evaluated for quality by three expert prostate radiologists. The compliance with PI-RADSv2.1 technical recommendations and the PI-QUALv2 score was calculated. Relationships between hardware, education of personnel, technical parameters, and/or patient preparation and both compliance and image quality were analysed using Pearson correlation, Mann-Whitney U-test, or Student's t-test where appropriate.
Results:
Forty-four medical centres submitted their compliance with PI-RADSv2.1 technical recommendations, and 26 medical centres completed the full survey. Thirteen hospitals provided 252 usable images. The mean compliance with technical recommendations was 79%. Inadequate PI-QUALv2 scores were given in 30.9% and 50.6% of the mp-MRI and bp-MRI examinations, respectively. Multiple factors with a possible relationship with image quality were identified.
Conclusion:
In the Netherlands, the average compliance with PI-RADSv2.1 technical recommendations is high. Prostate MRI image quality was inadequate in 30-50% of the provided examinations. Many factors not covered in the PI-RADSv2.1 technical recommendations can influence image quality. Improvement of prostate MRI image quality is needed.
Critical Relevance Statement:
It is essential to improve the image quality of prostate MRIs, which can be achieved by addressing factors not covered in the PI-RADSv2.1 technical recommendations.
Key Points:
Prostate MRI image quality influences the diagnostic accuracy of image-based decisions. Thirty to fifty percent of Dutch prostate MRI examinations were of inadequate image quality. We identified multiple factors with possible influence on image quality.
Insights
High compliance with prostate MRI guidelines exists in the Netherlands, yet 30-50% of prostate MRI scans show inadequate image quality. Addressing factors beyond current guidelines is crucial for improving diagnostic accuracy.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Prostate MRI quality is vital for accurate cancer diagnosis and treatment.
- Current guidelines (PI-RADSv2.1) aim to standardize prostate MRI acquisition.
- Variability in image quality can impact clinical decision-making.
Purpose of the Study:
- To assess compliance with PI-RADSv2.1 technical recommendations in the Netherlands.
- To evaluate the quality of prostate MRI examinations in Dutch centers.
- To identify factors influencing prostate MRI image quality for improvement.
Main Methods:
- A nationwide survey of 68 Dutch medical centers on prostate MRI acquisition practices.
- Expert radiologist evaluation of 252 anonymized prostate MRI scans from biopsy-naive patients.
- Calculation of PI-RADSv2.1 compliance and PI-QUALv2 scores.
- Statistical analysis of relationships between technical parameters, hardware, personnel education, patient preparation, and image quality.
Main Results:
- Mean compliance with PI-RADSv2.1 technical recommendations was 79%.
- 30.9% of multiparametric MRI (mp-MRI) and 50.6% of biparametric MRI (bp-MRI) scans received inadequate PI-QUALv2 scores.
- Multiple factors potentially influencing image quality were identified.
Conclusions:
- Dutch centers demonstrate high compliance with PI-RADSv2.1 technical recommendations.
- A significant proportion (30-50%) of prostate MRI examinations exhibit inadequate image quality.
- Factors not detailed in current guidelines significantly impact prostate MRI quality, necessitating further investigation and improvement strategies.
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