MRI of the Prostate in Germany: Online Survey among Radiologists

Abstract

Purpose: To assess structural, technical, and communicative aspects of dedicated MR examinations of the prostate (MRP) offered by radiologists in Germany. Materials and Methods: We conducted an eight-item online survey among members of the German Radiology Society (DRG). Radiological institutions were asked about their structure, i.?e., either hospital department (HD) or private practice (PP), number of board-certified radiologists, postal regions, number of MRPs in 2011, MR technology and MR sequences applied, ways to communicate results, and feedback from referring physicians on results of subsequent tests and procedures. Submissions were cleared of redundancies and anonymized. Differences in the number of positive replies to each item were statistically significant at p?<?0.05 for two-tailed testing in 2x2 tables. Results: The survey represented board-certified radiologists in 128 institutions (63 HDs and 65?PPs) in 67/95 German postal regions (71?%). Almost two-thirds of institutions performed 11?to 50 MRPs in 2011, more often at 1.5?T (116/128, 91?%) than at 3.0?T (36/128, 28?%), and most frequently with surface coils (1.5?T, 88/116, 76?%; 3.0?T, 34/36, 94?%; chi-square, 1.9736, 0.1?<?p?<?0.25). About two-thirds of 1.5?T users and 90?% of 3.0?T users applied at least one functional MR modality (diffusion-weighted imaging, dynamic contrast-enhanced imaging, or MR spectroscopy) for MRP. Reports including graphic representations of the prostate were applied by 21/128 institutions (16?%). Clinical feedback after MRP to radiologists other than upon their own request was infrequent (HDs, 32???45?%, PPs, 18???32?%). Conclusion: MRP was a widely available, small-volume examination among radiologists in Germany in 2011. The technology mainstay was a 1.5?T surface coil examination including at least one functional MR modality. Dedicated reporting and feedback mechanisms for quality control were underdeveloped. Key Points: ??MRI of the prostate was available in at least 67 of 95 German postal regions (71%) in 2011. ??MRI of the prostate was most often performed at 1.5T without an endorectal coil in Germany in 2011. ??At least two thirds of MRI-examinations of the prostate included both T2WI and at least one functional MR test (mostly DWI, less frequently MRS or DCE) in Germany in 2011. ??Structured reporting including graphic elements was offered by less than 20% of participating radiological institutions. ??Feedback to radiologists from referring physicians on subsequent test results in patients with MRI of the prostate most frequently came only upon special request by the radiologist. Citation Format: ??Mueller-Lisse UG, Lewerich B, Mueller-Lisse UL et?al. MRI of the Prostate in Germany: Online Survey among Radiologists. Fortschr R?ntgenstr 2015; 187: 703???711

Current Utilization and Acceptance of Multiparametric MRI in the Diagnosis of Prostate Cancer. A Regional Survey

“…Paradoxically, the majority of physicians considered the meaningfulness of the prostate MRI as only moderate or poor. One reason for this may be that there is so far no national standard based on which the urologist or treating physician can estimate the reliability of an MRI finding [17]. Studies of experienced centers show high detection rates and negative predictive values with standardized execution and evaluation of the MP-MRI [22,23].…”

“…However, attending physicians must be provided with a deeper understanding of MRI findings in order to make full use of the diagnostic potential of prostate MRI and to make the method overall more cost-effective [18,27]. The 2015 survey of German physicians criticized inadequate feedback from attending physicians to radiologists after prostate MRI [17]. This survey revealed that the majority of respondents were unaware of the PI-RADS classification and that no standardized localization scheme was used to document and explain findings.…”

“…A country-wide survey of German physicians in 2015 determined that MP-MRI was a widely-available examination procedure in Germany; however, there were complaints regarding the underdeveloped quality control-related diagnostic and feedback mechanisms [17]. The current survey is intended to go beyond a population survey and evaluate the acceptance and assessment of the importance of MP-MRI among patients and physicians in the diagnosis of prostate cancer.…”

Two-centre comparative experimental study of biparametric MRI at 3.0 T with and without endorectal coil using kiwifruit (Actinidia deliciosa) as a phantom for human prostate

“…ERC application in 3.0-T prostate MRI is one area of ongoing debate [3, 28]. One recent survey among 128 institutions reports that 36 (28%) examined prostates at 3.0 T, but only two (1.5% of all) applied ERCs at 3.0 T [2]. Another survey among 107 institutions found that 5.8% examined prostates with ERC at 3.0 T and 63.5% without ERC at 3.0 T [8].…”