A collaborative approach to improving prostate magnetic resonance image quality.

Area of Science:

• Medical Imaging
• Radiology
• Quality Improvement

Background:

• Poor magnetic resonance imaging (MRI) quality can compromise prostate cancer diagnosis.
• Institutional variability in patient preparation and lack of formal quality auditing impacted MRI quality.

Purpose of the Study:

• To enhance prostate MRI quality by increasing the percentage of exams meeting a PI-QUAL score of ≥4.
• To improve the proportion of exams with optimal Diffusion Weighted Imaging (DWI) sequences.

Main Methods:

• Standardized pre-MRI patient instructions (NPO, bladder emptying) and technologist education.
• Implemented weekly Prostate Imaging Quality (PI-QUAL) v1 scoring, integrated into the reporting system.
• Partnership with the American College of Radiology (ACR) Learning Network.

Main Results:

• Proportion of exams with PI-QUAL score ≥4 increased from 90% to 97%.
• Proportion of exams meeting optimal DWI criteria rose from 77% to 83%.
• Integrated scoring saved time; standardized instructions improved patient and staff understanding.

Conclusions:

• Consistent patient preparation, team collaboration, and standardized scoring improved prostate MRI quality without enemas.
• Achieved high PI-QUAL scores and DWI quality, meeting benchmarks from the ACR Learning Network.
• Quality improvement efforts demonstrated significant positive trends in prostate MRI assessment.