Objective To assess the staging accuracy of endorectal ively, for endorectal MRI, and 23% and 86% for TRUS. The sensitivity and specificity for diagnosing seminal magnetic resonance imaging (MRI), using a mid-field system, in patients with clinically localized prostate vesicle invasion were 100% and 94%, respectively, for endorectal MRI, and 33% and 100% for TRUS. The cancer and to compare the results with transrectal ultrasonography (TRUS).overall staging accuracy for endorectal MRI was 75% compared with 50% for TRUS. Patients and methods Twenty patients with clinically localized prostate cancer were prospectively staged Conclusion Compared with TRUS, endorectal MRI with a 0.5 T magnet provided greater sensitivity and speciwith TRUS and endorectal MRI using a 0.5 T magnet. All patients subsequently underwent radical prostatecficity for capsular penetration and increased sensitivity for seminal vesicle invasion. tomy and the results of pre-operative staging were compared with the histological findings.Keywords Prostate cancer, endorectal magnetic resonance imaging, transrectal ultrasonography, staging Results The sensitivity and specificity for diagnosing capsular penetration were 38% and 100%, respect-

ObjectivesFollowing a diagnosis of cancer, the detailed assessment of prognostic stage by radiology is a crucial determinant of initial therapeutic strategy offered to patients. Pretherapeutic stage by imaging is known to be inconsistently documented. We tested whether the completeness of cancer staging radiology reports could be improved through a nationally introduced pilot of proforma-based reporting for a selection of six common cancers.DesignProspective interventional study comparing the completeness of radiology cancer staging reports before and after the introduction of proforma reporting.SettingTwenty-one UK National Health Service hospitals.Participants1283 cancer staging radiology reports were submitted.Main outcome measuresRadiology staging reports across the six cancers types were evaluated before and after the implementation of proforma-based reporting. Report completeness was assessed using scoring forms listing the presence or absence of predetermined key staging data. Qualitative data regarding proforma implementation and usefulness were collected from questionnaires provided to radiologists and end-users.ResultsElectronic proforma-based reporting was successfully implemented in 15 of the 21 centres during the evaluation period. A total of 787 preproforma and 496 postproforma staging reports were evaluated. In the preproforma group, only 48.7% (5586/11 470) of key staging items were present compared with 87.3% (6043/6920) in the postproforma group. Thus, the introduction of proforma reporting produced a 78% improvement in staging completeness. This increase was seen across all cancer types and centres. The majority of participants found proforma reporting improved cancer reporting quality for their clinical practice.ConclusionThe implementation of proforma reporting results in a significant improvement in the completeness of cancer staging reports. Proforma-based assessment of cancer stage enables objective comparisons of patient outcomes across centres. It should therefore become an auditable quality standard for cancer care.

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The objective of this study was to devise and implement a Europe-wide study on referral guidelines for radiological imaging in the EU Member States in order to identify potential major issues, important differences between Member States and good practices. A web-based survey was used to assess the availability of imaging referral guidelines, development methodology and preferences for future initiatives for European community action to facilitate justification and appropriate use of radiological diagnostic procedures. A questionnaire was distributed to representatives of national radiological and nuclear medicine societies as well as to competent authorities for radiation protection in 30 European countries, including all 28 EU Member States. Responses were collated and analysed to produce a series of conclusions and recommendations.