Journal: European radiology
This article presents a structured, quality-improvement roadmap to standardise and upgrade prostate MRI practice, with the goal of improving diagnostic accuracy and consistency across centres.
The authors, from the ESUR Prostate MRI Working Group Quality Improvement Subgroup, describe a three-step framework:
- 1. “Build it right” – Technical excellence
- – Enforce adherence to Prostate Imaging Reporting and Data System (PI-RADS) technical standards for image acquisition.
- – Use the Prostate Imaging Quality (PI-QUAL) score for objective assessment of image quality.
- – Systematically identify and minimise artefacts that degrade diagnostic performance.
- 2. “See it right” – Interpretive excellence
- – Implement structured training and education in prostate MRI reading.
- – Use institutional quality assurance metrics (e.g., audit of imaging–biopsy correlation and outcomes).
- – Strengthen multidisciplinary collaboration (radiology–urology–oncology–pathology) to align imaging interpretation with clinical decision-making.
- 3. “Improve and innovate” – Continuous refinement
- – Incorporate emerging tools such as AI-based quality assessment, deep learning reconstruction for image optimisation, and remote supervision/mentoring.
- – Encourage ongoing benchmarking and iterative improvements in protocols and reporting.
The central message is that variation in acquisition, quality, and reporting currently limits the full clinical value of prostate MRI. Systematically applying this three-step framework is proposed as a way to deliver more reliable, reproducible, and patient-centred prostate cancer imaging, with a call for international implementation and outcome-based validation.