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 statementIt 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 PointsProstate 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.