Regional Standardization of Prostate Multiparametric MRI Performance and Reporting: Is There a Role for a Director of Prostate Imaging?

Abstract

OBJECTIVE. The purpose of this study was to assess prostate multiparametric MRI (mpMRI) before and after intervention by a director of prostate imaging. MATERIALS AND METHODS. Images from prostate mpMRI examinations at four peripheral institutions (five 1.5-T systems) were studied. DICOM headers were analyzed for T2-weighted, DWI, and dynamic contrast-enhanced technical specifications. Reports were retrieved, and a blinded radiologist compared them with those from the regional academic referral center (3-T system) and Prostate Imaging and Data Reporting System version 2 (PI-RADSv2) technical specifications. Data were reevaluated after intervention by a director of prostate imaging. Comparisons were performed by chi-square analysis. RESULTS. Except for having insufficient DWI spatial resolution, the referral center fully complied with PI-RADSv2. For peripheral systems, compliance with PI-RADSv2 technical specifications improved from baseline to after intervention. For T2-weighted imaging, compliance with spatial resolution increased from 40% (two of five MRI systems) to 100% (all five systems) (p = 0.038). For DWI, spatial resolution compliance increased from 20% to 100%. For modified DWI, spatial resolution compliance to improve image quality at 1.5 T (matrix, 100 × 100; FOV, 28 × 28 cm; slice thickness, 4 mm) increased from 60% (b value ≥ 1400 s/mm2) to 100% (p = 0.114). For dynamic contrast-enhanced imaging, spatial resolution compliance increased from 60% to 100% (p = 0.114), temporal resolution compliance increased from 20% (≤ 10 seconds) to 100% (p = 0.10), and acquisition time compliance increased from 60% (≥ 2 minutes) to 100% (p = 0.114). Only one of the four peripheral centers provided PI-RADSv2 scores, but all of them did after the intervention (p = 0.028). CONCLUSION. A director of prostate imaging may drive standardization of prostate MRI performance and reporting within specified geographic regions.