Regional Standardization of Prostate Multiparametric MRI Performance and Reporting: Is There a Role for a Director of Prostate Imaging?
Jorge Abreu-Gomez1, Wael Shabana1, Matthew D. F. McInnes1, Joseph P. O'Sullivan1 ... Show all
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Citation: American Journal of Roentgenology: 1-7. 10.2214/AJR.19.21111
AbstractFull TextReferencesPDFPDF PlusAdd to FavoritesPermissionsDownload Citation
ABSTRACT :
OBJECTIVE. The purpose of this study was to assess prostate multiparametric MRI (mpMRI) before and after intervention by a director of prostate imaging.
MATERIALS AND METHODS. Images from prostate mpMRI examinations at four peripheral institutions (five 1.5-T systems) were studied. DICOM headers were analyzed for T2-weighted, DWI, and dynamic contrast-enhanced technical specifications. Reports were retrieved, and a blinded radiologist compared them with those from the regional academic referral center (3-T system) and Prostate Imaging and Data Reporting System version 2 (PI-RADSv2) technical specifications. Data were reevaluated after intervention by a director of prostate imaging. Comparisons were performed by chi-square analysis.
RESULTS. Except for having insufficient DWI spatial resolution, the referral center fully complied with PI-RADSv2. For peripheral systems, compliance with PI-RADSv2 technical specifications improved from baseline to after intervention. For T2-weighted imaging, compliance with spatial resolution increased from 40% (two of five MRI systems) to 100% (all five systems) (p = 0.038). For DWI, spatial resolution compliance increased from 20% to 100%. For modified DWI, spatial resolution compliance to improve image quality at 1.5 T (matrix, 100 × 100; FOV, 28 × 28 cm; slice thickness, 4 mm) increased from 60% (b value ≥ 1400 s/mm2) to 100% (p = 0.114). For dynamic contrast-enhanced imaging, spatial resolution compliance increased from 60% to 100% (p = 0.114), temporal resolution compliance increased from 20% (≤ 10 seconds) to 100% (p = 0.10), and acquisition time compliance increased from 60% (≥ 2 minutes) to 100% (p = 0.114). Only one of the four peripheral centers provided PI-RADSv2 scores, but all of them did after the intervention (p = 0.028).
CONCLUSION. A director of prostate imaging may drive standardization of prostate MRI performance and reporting within specified geographic regions.
Keywords: director of prostate imaging, MRI, PI-RADS, prostate, Prostate Imaging and Data Reporting System, standardization
Based on a presentation at the Society of Abdominal Radiology 2019 annual meeting, Orlando, FL.
References
Previous section
1. Ahmed HU, El-Shater Bosaily A, Brown LC, et al. PROMIS study group. Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet 2017; 389:815–822 [Crossref] [Medline] [Google Scholar]
2. Kasivisvanathan V, Emberton M, Moore CM. MRI-targeted biopsy for prostate-cancer diagnosis. N Engl J Med 2018; 379:589–590 [Crossref] [Medline] [Google Scholar]
3. Weinreb JC, Barentsz JO, Choyke PL, et al. PI-RADS Prostate Imaging—Reporting and Data System: 2015, version 2. Eur Urol 2016; 69:16–40 [Crossref] [Medline] [Google Scholar]
4. Barentsz JO, Weinreb JC, Verma S, et al. Synopsis of the PI-RADS v2 guidelines for multiparametric prostate magnetic resonance imaging and recommendations for use. Eur Urol 2016; 69:41–49 [Crossref] [Medline] [Google Scholar]
5. Padhani AR, Weinreb J, Rosenkrantsz AB, Villeirs G, Turkbey B, Barentsz J. PI-RADS v2 status update and future directions. Eur Urol 2019; 75:385–396 [Crossref] [Medline] [Google Scholar]
6. Rosenkrantz AB, Oto A, Turkbey B, Westphalen AC. Prostate Imaging Reporting and Data System (PI-RADS), version 2: a critical look. AJR 2016; 206:1179–1183 [Abstract] [Google Scholar]
7. Woo S, Suh CH, Kim SY, Cho JY, Kim SH. Diagnostic performance of Prostate Imaging Reporting and Data System version 2 for detection of prostate cancer: a systematic review and diagnostic meta-analysis. Eur Urol 2017; 72:177–188 [Crossref] [Medline] [Google Scholar]
8. Purysko AS, Rosenkrantz AB. Technique of multiparametric MR imaging of the prostate. Urol Clin North Am 2018; 45:427–438 [Crossref] [Medline] [Google Scholar]
9. Hassanzadeh E, Glazer DI, Dunne RM, Fennessy FM, Harisinghani MG, Tempany CM. Prostate imaging reporting and data system version 2 (PI-RADS v2): a pictorial review. Abdom Radiol (NY) 2017; 42:278–289 [Crossref] [Medline] [Google Scholar]
10. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin 2018; 68:7–30 [Crossref] [Medline] [Google Scholar]
11. Canadian Cancer Society website. Canadian Cancer Statistics. www.canada.ca/en/public-health/services/chronic-diseases/cancer/canadian-cancer-statistics.html. 2017. Accessed April 17, 2019 [Google Scholar]
12. Champlain Local Health Integration Network website. Introduction. www.champlainlhin.on.ca/AboutUs/Intro.aspx. 2014. Accessed December 17, 2018 [Google Scholar]
13. Westphalen AC, Margolis DJ, Rosenkrantz AB. The director of prostate imaging: advancing care for prostate cancer patients. Abdom Radiol (NY) 2017; 42:2358–2362 [Crossref] [Medline] [Google Scholar]
14. Ullrich T, Quentin M, Oelers C, et al. Magnetic resonance imaging of the prostate at 1.5 versus 3.0T: a prospective comparison study of image quality. Eur J Radiol 2017; 90:192–197 [Crossref] [Medline] [Google Scholar]
15. Soher BJ, Dale BM, Merkle EM. A review of MR physics: 3T versus 1.5T. Magn Reson Imaging Clin N Am 2007; 15:277–290 [Crossref] [Medline] [Google Scholar]
16. Rouvière O, Hartman RP, Lyonnet D. Prostate MR imaging at high-field strength: evolution or revolution? Eur Radiol 2006; 16:276–284 [Crossref] [Medline] [Google Scholar]
17. Moran K, Breau RH, Cagiannos I, et al. Standardized reporting templates with mandatory reporting fields and “pick-list” options improve use of Prostate Imaging and Data Reporting System version 2 in clinical practice: a plan-do-study-act analysis. Can Urol Assoc J 2018 Nov 5 [Epub ahead of print] [Google Scholar]
18. Esses SJ, Taneja SS, Rosenkrantz AB. Imaging facilities' adherence to PI-RADS v2 minimum technical standards for the performance of prostate MRI. Acad Radiol 2018; 25:188–195 [Crossref] [Medline] [Google Scholar]
19. Kitajima K, Takahashi S, Ueno Y, et al. Clinical utility of apparent diffusion coefficient values obtained using high b-value when diagnosing prostate cancer using 3 tesla MRI: comparison between ultrahigh b-value (2000 s/mm2) and standard high b-value (1000 s/mm2). J Magn R eson Imaging 2012; 36:198–205 [Crossref] [Medline] [Google Scholar]
20. Rosenkrantz AB, Hindman N, Lim RP, et al. Diffusion-weighted imaging of the prostate: comparison of b1000 and b2000 image sets for index lesion detection. J Magn Reson Imaging 2013; 38:694–700 [Crossref] [Medline] [Google Scholar]
21. Turkbey B, Rosenkrantz AB, Haider MA, et al. Prostate Imaging Reporting and Data System version 2.1: 2019 update of Prostate Imaging Reporting and Data System version 2. Eur Urol 2019; 232:1–12 [Google Scholar]
22. Tamada T, Prabhu V, Li J, Babb JS, Taneja SS, Rosenkrantz AB. Prostate cancer: diffusion-weighted MR imaging for detection and assessment of aggressiveness-comparison between conventional and kurtosis models. Radiology 2017; 284:100–108 [Crossref] [Medline] [Google Scholar]
23. Othman AE, Falkner F, Weiss J, et al. Effect of temporal resolution on diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging of the prostate. Invest Radiol 2016; 51:290–296 [Crossref] [Medline] [Google Scholar]
24. Ream JM, Doshi AM, Dunst D, et al. Dynamic contrast-enhanced MRI of the prostate: an intraindividual assessment of the effect of temporal resolution on qualitative detection and quantitative analysis of histopathologically proven prostate cancer. J Magn Reson Imaging 2017; 45:1464–1475 [Crossref] [Medline] [Google Scholar]
25. Boesen L, Nørgaard N, Løgager V, et al. Assessment of the diagnostic accuracy of biparametric magnetic resonance imaging for prostate cancer in biopsy-naive men: the Biparametric MRI for Detection of Prostate Cancer (BIDOC) Study. JAMA Netw Open 2018; 1:e180219 [Crossref] [Medline] [Google Scholar]
26. Scialpi M, Aisa MC, D'Andrea A, Martorana E. Simplified Prostate Imaging Reporting and Data System for biparametric prostate MRI: a proposal. AJR 2018; 211:379–382 [Abstract] [Google Scholar]
27. Rosenkrantz AB, Oto A, Turkbey B, Westphalen AC. Reply to “standardizing biparametric MRI to simplify and improve Prostate Imaging Reporting and Data System, version 2, in prostate cancer management.”. AJR 2016; 207:[web]W76 [Abstract] [Google Scholar]
28. Luzzago S, Petralia G, Musi G, et al. Multipara-metric magnetic resonance imaging second opinion may reduce the number of unnecessary prostate biopsies: time to improve radiologists' training program? Clin Genitourin Cancer 2018 Oct 23 [Epub ahead of print] [Google Scholar]
29. Wibmer A, Vargas HA, Donahue TF, et al. Diagnosis of extracapsular extension of prostate cancer on prostate MRI: impact of second-opinion readings by subspecialized genitourinary oncologic radiologists. AJR 2015; 205:[web]W73–W78 [Abstract] [Google Scholar]
30. Hansen NL, Koo BC, Gallagher FA, et al. Comparison of initial and tertiary centre second opinion reads of multiparametric magnetic resonance imaging of the prostate prior to repeat biopsy. Eur Radiol 2017; 27:2259–2266 [Crossref] [Medline] [Google Scholar]
31. Rosenkrantz AB, Ginocchio LA, Cornfeld D, et al. Interobserver reproducibility of the PI-RADS version 2 lexicon: a multicenter study of six experienced prostate radiologists. Radiology 2016; 280:793–804 [Crossref] [Medline] [Google Scholar]
32. Spilseth B, Ghai S, Patel NU, Taneja SS, Margolis DJ, Rosenkrantz AB. A comparison of radiologists' and urologists' opinions regarding prostate MRI reporting: results from a survey of specialty societies. AJR 2018; 210:101–107 [Abstract] [Google Scholar]
33. Rosenkrantz AB, Pujara AC, Taneja SS. Use of a quality improvement initiative to achieve consistent reporting of level of suspicion for tumor on multiparametric prostate MRI. AJR 2016; 206:1040–1044 [Abstract] [Google Scholar]
34. Barentsz JO, Richenberg J, Clements R, et al. European Society of Urogenital Radiology. ESUR prostate MR guidelines 2012. Eur Radiol 2012; 22:746–757 [Crossref] [Medline] [Google Scholar]
35. Petralia G, Musi G, Padhani AR, et al. Robot-assisted radical prostatectomy: multiparametric MR imaging-directed intraoperative frozen-section analysis to reduce the rate of positive surgical margins. Radiology 2015; 274:434–444 [Crossref] [Medline] [Google Scholar]
Address correspondence to N. Schieda (nschieda@toh.ca).
Read More: https://www.ajronline.org/doi/abs/10.2214/AJR.19.21111
Jorge Abreu-Gomez1, Wael Shabana1, Matthew D. F. McInnes1, Joseph P. O'Sullivan1 ... Show all
Share Share
+ Affiliations:
Citation: American Journal of Roentgenology: 1-7. 10.2214/AJR.19.21111
AbstractFull TextReferencesPDFPDF PlusAdd to FavoritesPermissionsDownload Citation
ABSTRACT :
OBJECTIVE. The purpose of this study was to assess prostate multiparametric MRI (mpMRI) before and after intervention by a director of prostate imaging.
MATERIALS AND METHODS. Images from prostate mpMRI examinations at four peripheral institutions (five 1.5-T systems) were studied. DICOM headers were analyzed for T2-weighted, DWI, and dynamic contrast-enhanced technical specifications. Reports were retrieved, and a blinded radiologist compared them with those from the regional academic referral center (3-T system) and Prostate Imaging and Data Reporting System version 2 (PI-RADSv2) technical specifications. Data were reevaluated after intervention by a director of prostate imaging. Comparisons were performed by chi-square analysis.
RESULTS. Except for having insufficient DWI spatial resolution, the referral center fully complied with PI-RADSv2. For peripheral systems, compliance with PI-RADSv2 technical specifications improved from baseline to after intervention. For T2-weighted imaging, compliance with spatial resolution increased from 40% (two of five MRI systems) to 100% (all five systems) (p = 0.038). For DWI, spatial resolution compliance increased from 20% to 100%. For modified DWI, spatial resolution compliance to improve image quality at 1.5 T (matrix, 100 × 100; FOV, 28 × 28 cm; slice thickness, 4 mm) increased from 60% (b value ≥ 1400 s/mm2) to 100% (p = 0.114). For dynamic contrast-enhanced imaging, spatial resolution compliance increased from 60% to 100% (p = 0.114), temporal resolution compliance increased from 20% (≤ 10 seconds) to 100% (p = 0.10), and acquisition time compliance increased from 60% (≥ 2 minutes) to 100% (p = 0.114). Only one of the four peripheral centers provided PI-RADSv2 scores, but all of them did after the intervention (p = 0.028).
CONCLUSION. A director of prostate imaging may drive standardization of prostate MRI performance and reporting within specified geographic regions.
Keywords: director of prostate imaging, MRI, PI-RADS, prostate, Prostate Imaging and Data Reporting System, standardization
Based on a presentation at the Society of Abdominal Radiology 2019 annual meeting, Orlando, FL.
References
Previous section
1. Ahmed HU, El-Shater Bosaily A, Brown LC, et al. PROMIS study group. Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet 2017; 389:815–822 [Crossref] [Medline] [Google Scholar]
2. Kasivisvanathan V, Emberton M, Moore CM. MRI-targeted biopsy for prostate-cancer diagnosis. N Engl J Med 2018; 379:589–590 [Crossref] [Medline] [Google Scholar]
3. Weinreb JC, Barentsz JO, Choyke PL, et al. PI-RADS Prostate Imaging—Reporting and Data System: 2015, version 2. Eur Urol 2016; 69:16–40 [Crossref] [Medline] [Google Scholar]
4. Barentsz JO, Weinreb JC, Verma S, et al. Synopsis of the PI-RADS v2 guidelines for multiparametric prostate magnetic resonance imaging and recommendations for use. Eur Urol 2016; 69:41–49 [Crossref] [Medline] [Google Scholar]
5. Padhani AR, Weinreb J, Rosenkrantsz AB, Villeirs G, Turkbey B, Barentsz J. PI-RADS v2 status update and future directions. Eur Urol 2019; 75:385–396 [Crossref] [Medline] [Google Scholar]
6. Rosenkrantz AB, Oto A, Turkbey B, Westphalen AC. Prostate Imaging Reporting and Data System (PI-RADS), version 2: a critical look. AJR 2016; 206:1179–1183 [Abstract] [Google Scholar]
7. Woo S, Suh CH, Kim SY, Cho JY, Kim SH. Diagnostic performance of Prostate Imaging Reporting and Data System version 2 for detection of prostate cancer: a systematic review and diagnostic meta-analysis. Eur Urol 2017; 72:177–188 [Crossref] [Medline] [Google Scholar]
8. Purysko AS, Rosenkrantz AB. Technique of multiparametric MR imaging of the prostate. Urol Clin North Am 2018; 45:427–438 [Crossref] [Medline] [Google Scholar]
9. Hassanzadeh E, Glazer DI, Dunne RM, Fennessy FM, Harisinghani MG, Tempany CM. Prostate imaging reporting and data system version 2 (PI-RADS v2): a pictorial review. Abdom Radiol (NY) 2017; 42:278–289 [Crossref] [Medline] [Google Scholar]
10. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin 2018; 68:7–30 [Crossref] [Medline] [Google Scholar]
11. Canadian Cancer Society website. Canadian Cancer Statistics. www.canada.ca/en/public-health/services/chronic-diseases/cancer/canadian-cancer-statistics.html. 2017. Accessed April 17, 2019 [Google Scholar]
12. Champlain Local Health Integration Network website. Introduction. www.champlainlhin.on.ca/AboutUs/Intro.aspx. 2014. Accessed December 17, 2018 [Google Scholar]
13. Westphalen AC, Margolis DJ, Rosenkrantz AB. The director of prostate imaging: advancing care for prostate cancer patients. Abdom Radiol (NY) 2017; 42:2358–2362 [Crossref] [Medline] [Google Scholar]
14. Ullrich T, Quentin M, Oelers C, et al. Magnetic resonance imaging of the prostate at 1.5 versus 3.0T: a prospective comparison study of image quality. Eur J Radiol 2017; 90:192–197 [Crossref] [Medline] [Google Scholar]
15. Soher BJ, Dale BM, Merkle EM. A review of MR physics: 3T versus 1.5T. Magn Reson Imaging Clin N Am 2007; 15:277–290 [Crossref] [Medline] [Google Scholar]
16. Rouvière O, Hartman RP, Lyonnet D. Prostate MR imaging at high-field strength: evolution or revolution? Eur Radiol 2006; 16:276–284 [Crossref] [Medline] [Google Scholar]
17. Moran K, Breau RH, Cagiannos I, et al. Standardized reporting templates with mandatory reporting fields and “pick-list” options improve use of Prostate Imaging and Data Reporting System version 2 in clinical practice: a plan-do-study-act analysis. Can Urol Assoc J 2018 Nov 5 [Epub ahead of print] [Google Scholar]
18. Esses SJ, Taneja SS, Rosenkrantz AB. Imaging facilities' adherence to PI-RADS v2 minimum technical standards for the performance of prostate MRI. Acad Radiol 2018; 25:188–195 [Crossref] [Medline] [Google Scholar]
19. Kitajima K, Takahashi S, Ueno Y, et al. Clinical utility of apparent diffusion coefficient values obtained using high b-value when diagnosing prostate cancer using 3 tesla MRI: comparison between ultrahigh b-value (2000 s/mm2) and standard high b-value (1000 s/mm2). J Magn R eson Imaging 2012; 36:198–205 [Crossref] [Medline] [Google Scholar]
20. Rosenkrantz AB, Hindman N, Lim RP, et al. Diffusion-weighted imaging of the prostate: comparison of b1000 and b2000 image sets for index lesion detection. J Magn Reson Imaging 2013; 38:694–700 [Crossref] [Medline] [Google Scholar]
21. Turkbey B, Rosenkrantz AB, Haider MA, et al. Prostate Imaging Reporting and Data System version 2.1: 2019 update of Prostate Imaging Reporting and Data System version 2. Eur Urol 2019; 232:1–12 [Google Scholar]
22. Tamada T, Prabhu V, Li J, Babb JS, Taneja SS, Rosenkrantz AB. Prostate cancer: diffusion-weighted MR imaging for detection and assessment of aggressiveness-comparison between conventional and kurtosis models. Radiology 2017; 284:100–108 [Crossref] [Medline] [Google Scholar]
23. Othman AE, Falkner F, Weiss J, et al. Effect of temporal resolution on diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging of the prostate. Invest Radiol 2016; 51:290–296 [Crossref] [Medline] [Google Scholar]
24. Ream JM, Doshi AM, Dunst D, et al. Dynamic contrast-enhanced MRI of the prostate: an intraindividual assessment of the effect of temporal resolution on qualitative detection and quantitative analysis of histopathologically proven prostate cancer. J Magn Reson Imaging 2017; 45:1464–1475 [Crossref] [Medline] [Google Scholar]
25. Boesen L, Nørgaard N, Løgager V, et al. Assessment of the diagnostic accuracy of biparametric magnetic resonance imaging for prostate cancer in biopsy-naive men: the Biparametric MRI for Detection of Prostate Cancer (BIDOC) Study. JAMA Netw Open 2018; 1:e180219 [Crossref] [Medline] [Google Scholar]
26. Scialpi M, Aisa MC, D'Andrea A, Martorana E. Simplified Prostate Imaging Reporting and Data System for biparametric prostate MRI: a proposal. AJR 2018; 211:379–382 [Abstract] [Google Scholar]
27. Rosenkrantz AB, Oto A, Turkbey B, Westphalen AC. Reply to “standardizing biparametric MRI to simplify and improve Prostate Imaging Reporting and Data System, version 2, in prostate cancer management.”. AJR 2016; 207:[web]W76 [Abstract] [Google Scholar]
28. Luzzago S, Petralia G, Musi G, et al. Multipara-metric magnetic resonance imaging second opinion may reduce the number of unnecessary prostate biopsies: time to improve radiologists' training program? Clin Genitourin Cancer 2018 Oct 23 [Epub ahead of print] [Google Scholar]
29. Wibmer A, Vargas HA, Donahue TF, et al. Diagnosis of extracapsular extension of prostate cancer on prostate MRI: impact of second-opinion readings by subspecialized genitourinary oncologic radiologists. AJR 2015; 205:[web]W73–W78 [Abstract] [Google Scholar]
30. Hansen NL, Koo BC, Gallagher FA, et al. Comparison of initial and tertiary centre second opinion reads of multiparametric magnetic resonance imaging of the prostate prior to repeat biopsy. Eur Radiol 2017; 27:2259–2266 [Crossref] [Medline] [Google Scholar]
31. Rosenkrantz AB, Ginocchio LA, Cornfeld D, et al. Interobserver reproducibility of the PI-RADS version 2 lexicon: a multicenter study of six experienced prostate radiologists. Radiology 2016; 280:793–804 [Crossref] [Medline] [Google Scholar]
32. Spilseth B, Ghai S, Patel NU, Taneja SS, Margolis DJ, Rosenkrantz AB. A comparison of radiologists' and urologists' opinions regarding prostate MRI reporting: results from a survey of specialty societies. AJR 2018; 210:101–107 [Abstract] [Google Scholar]
33. Rosenkrantz AB, Pujara AC, Taneja SS. Use of a quality improvement initiative to achieve consistent reporting of level of suspicion for tumor on multiparametric prostate MRI. AJR 2016; 206:1040–1044 [Abstract] [Google Scholar]
34. Barentsz JO, Richenberg J, Clements R, et al. European Society of Urogenital Radiology. ESUR prostate MR guidelines 2012. Eur Radiol 2012; 22:746–757 [Crossref] [Medline] [Google Scholar]
35. Petralia G, Musi G, Padhani AR, et al. Robot-assisted radical prostatectomy: multiparametric MR imaging-directed intraoperative frozen-section analysis to reduce the rate of positive surgical margins. Radiology 2015; 274:434–444 [Crossref] [Medline] [Google Scholar]
Address correspondence to N. Schieda (nschieda@toh.ca).
Read More: https://www.ajronline.org/doi/abs/10.2214/AJR.19.21111
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