The Royal College of Radiologists' Re-Audit of UK Prostate Brachytherapy Delivery

The Royal College of Radiologists' (RCR) audit of prostate brachytherapy was initially performed in 2012 and provided the first comprehensive picture of the use of prostate brachytherapy in the UK. A re-audit in 2022 examined the adherence to audit standards based on national and international guidelines.

A web-based data collection tool was developed by The RCR Quality Improvement and Audit Committee and sent to audit leads at all cancer centres in the United Kingdom (UK). Standards were developed based on available guidelines in use at the start of 2021 covering casemix and dosimetry. Audit findings were compared with the 2012 RCR audit and other audits across the world.

Fifty-three of 59 cancer centres submitted data. Twenty-five centres reported carrying out prostate brachytherapy and provided data regarding the number of implants, staffing, dosimetry, medication, anaesthesia, and follow-up. There was a decrease in overall prostate brachytherapy numbers with only 79% and 56% of centres treating >25 low-dose rate (LDR) and high-dose rate (HDR) cases per year, respectively. Only 43% (6/14 for LDR) and 31 % (5/16 for HDR) of oncologists performed more than 25 procedures. However, there was an increase in the skill mix of the departments and all centres have been performing post LDR implant dosimetry.

This audit provides a comprehensive picture of changes in prostate brachytherapy in the UK over the last 10 years since 2012. The number of prostate brachytherapy implants carried out in the UK has decreased since 2012. Many centres were unable to maintain minimum numbers of cases for compliance to guidelines, risking inadequate experience to maintain competence. The declining trends are similar to practice in the USA and Europe.