PI-RADSv2 compliance improves after input from director of prostate imaging

Selecting a staff member to serve as a director of prostate imaging can improve compliance with technical standards and lead to better overall patient care, according to findings published in the American Journal of Roentgenology.

The use of prostate multiparametric MRI (mpMRI) has been a game-changer for treating prostate cancer, explained Jorge Abreu-Gomez, department of medical imaging at the University of Ottawa, and colleagues. And the Prostate Imaging and Data Reporting System version 2 (PI-RADSv2) was published by the American College of Radiology and European Society of Urogenital Radiology in 2015 to help guide the management of prostate mpMRI. Compliance with PI-RADSv2, however, remains inconsistent.  

Could designating one person to serve as a director of prostate imaging help improve compliance?

“To our knowledge, no studies have assessed the value that such directors might have if their influence were applied to larger geographic regions and patient populations beyond their own institutions,” the authors wrote. “The purpose of this study was to determine the potential importance of a director of prostate imaging for standardizing prostate mpMRI performance and reporting within a specified geographic region.”

Abreu-Gomez et al. examined data from five hospitals, tracking prostate mpMRI examinations performed at each site and checking them for PI-RADSv2 compliance. An intervention from the referral center’s director of prostate imaging occurred in June 2018. During that intervention, the director reviewed each site’s technical specifications and helped them comply with all applicable PI-RADSv2 standards. A standardized reporting template was also shared with leadership at each location.

The authors compared each site’s performance before and after the intervention and noted significant improvements. For T2-weighted imaging, for example, compliance with spatial resolution jumped from 40% to 100%. For DWI, spatial resolution compliance increased from 20% to 100%. Modified DWI and dynamic contrast-enhanced imaging also saw spatial resolution compliance move all the way to 100%.

“A director of prostate imaging leadership model can positively affect prostate MRI performance and interpretation within a specified geographic region and assure PI-RADSv2 compliance both within institutions and at referral centers,” the authors concluded. “This in turn can reduce the number of examinations repeated because of insufficient technique or incomplete reports and improve care of patients with prostate cancer, also easing demands for MRI resources in health care systems.”