Quality of prostate MRI in early diagnosis-a national survey and reading evaluation.

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.