PIRADS for Rad Oncs: A Multidisciplinary Educational Lecture to Improve Prostate MRI Interpretation for Radiation Oncology Residents

Abstract

Background The Prostate Imaging Reporting and Data System (PIRADS) reported on multiparametric magnetic resonance imaging (mpMRI) is a standard assessment in the diagnostic workup for patients with prostate adenocarcinoma. Therapeutically, mpMRI and PIRADS lesions are increasingly utilized in radiation oncology target delineation for definitive treatment with either external beam radiation therapy or brachytherapy. Though imaging interpretation is an integral component of radiation oncology, formal education is limited. Here we report on an educational lecture created with radiology colleagues to increase knowledge and confidence in mpMRI and PIRADS. Methods An educational lecture was created to summarize the aims and limitations of the PIRADS version 2.1 and to review the relationship of mpMRI, PIRADS scoring, and the dominant intraprostatic lesion (DIL). Educational materials were reviewed by a radiology fellow specialized in body MRI and two faculty radiation oncologists; a radiology fellow also attended the lecture. Radiation oncology residents from three institutions participated in the lecture and completed a pre-lecture (pre-test) and post-lecture (post-test) survey. The surveys assessed the participants' confidence and knowledge in PIRADS and mpMRI. Confidence was assessed using Likert scales ranging from 1-5. The knowledge assessment portion consisted of true/false, dichotomous choice, and multiple choice questions. Statistical Analysis: Likert confidence ratings pre- and post-lecture were averaged separately for each participant. A Wilcoxon Signed Rank test was performed to compare average confidence ratings. A paired sample t-test was performed to compare pre-lecture and post-lecture raw scores of the knowledge assessment section. All statistical analysis was performed using IBM SPSS Statistics for Mac, Version 28.0. (Armonk, NY: IBM Corp). Results 13 participants completed a pre-test survey and attended the lecture. 11/13 (85%) of participants completed a post-test survey. The median pre-test confidence score was 1.6 (Range 1-4), indicating that participants did not feel confident in PIRADS interpretation and mpMRI. The median knowledge assessment pre-test score was 58.3% and significantly improved by 43% after the lecture, with a median post-test score of 83.3% (Range 50%-100%, p<0.001). Participant median confidence score increased to 4.1 (Range 2-5, p=0.003) suggesting increased confidence in interpreting PIRADS and mpMRI. Discussion Radiation oncology residents do not feel confident in PIRADS scoring and imaging interpretation on mpMRI. Formal educational lectures can improve resident comfort and knowledge in PIRADS, and multidisciplinary lectures in collaboration with radiology colleagues should be encouraged. The Prostate Imaging Reporting and Data System (PIRADS) reported on multiparametric magnetic resonance imaging (mpMRI) is a standard assessment in the diagnostic workup for patients with prostate adenocarcinoma. Therapeutically, mpMRI and PIRADS lesions are increasingly utilized in radiation oncology target delineation for definitive treatment with either external beam radiation therapy or brachytherapy. Though imaging interpretation is an integral component of radiation oncology, formal education is limited. Here we report on an educational lecture created with radiology colleagues to increase knowledge and confidence in mpMRI and PIRADS. An educational lecture was created to summarize the aims and limitations of the PIRADS version 2.1 and to review the relationship of mpMRI, PIRADS scoring, and the dominant intraprostatic lesion (DIL). Educational materials were reviewed by a radiology fellow specialized in body MRI and two faculty radiation oncologists; a radiology fellow also attended the lecture. Radiation oncology residents from three institutions participated in the lecture and completed a pre-lecture (pre-test) and post-lecture (post-test) survey. The surveys assessed the participants' confidence and knowledge in PIRADS and mpMRI. Confidence was assessed using Likert scales ranging from 1-5. The knowledge assessment portion consisted of true/false, dichotomous choice, and multiple choice questions. Statistical Analysis: Likert confidence ratings pre- and post-lecture were averaged separately for each participant. A Wilcoxon Signed Rank test was performed to compare average confidence ratings. A paired sample t-test was performed to compare pre-lecture and post-lecture raw scores of the knowledge assessment section. All statistical analysis was performed using IBM SPSS Statistics for Mac, Version 28.0. (Armonk, NY: IBM Corp). 13 participants completed a pre-test survey and attended the lecture. 11/13 (85%) of participants completed a post-test survey. The median pre-test confidence score was 1.6 (Range 1-4), indicating that participants did not feel confident in PIRADS interpretation and mpMRI. The median knowledge assessment pre-test score was 58.3% and significantly improved by 43% after the lecture, with a median post-test score of 83.3% (Range 50%-100%, p<0.001). Participant median confidence score increased to 4.1 (Range 2-5, p=0.003) suggesting increased confidence in interpreting PIRADS and mpMRI. Radiation oncology residents do not feel confident in PIRADS scoring and imaging interpretation on mpMRI. Formal educational lectures can improve resident comfort and knowledge in PIRADS, and multidisciplinary lectures in collaboration with radiology colleagues should be encouraged.