We as urologist expect several things from the radiologist reading and reporting mpMRI of the prostate. The mpMRI should give good quality results and enable us to locate suspicious lesions with high probability of being significant prostate cancer. The images should allow us to plan targeted biopsies, treatment and adequate follow-up. The results should be reproducible and standardized. Finally, the mpMRI produced report will hopefully allow us to convey the results to the patients in a simple manner as well.
In order for mpMRI to live up to all these expectations, certain conditions must be met including those involving equipment details, team members and the radiologist himself. The radiologist must be knowledgeable, experienced, have regular feedback on his work and continue education on a regular basis.
For the radiologist to be initially educated, he must have full knowledge on the PIRADS system, mpMRI technique, reporting procedure and must have read at least 50-100 typical cases. For the more experienced radiologist, in the intermediate period, he must have already read 100-150 cases and to be completely autonomous, he must continue to read 50-100 cases per year on a regular basis.
Feedback is a critical process to the radiologist. He must have radiopathologic correlations for his readings, participate in multidisciplinary discussion group meetings and be exposed to all the false negative and positives of his reports. Additionally, a prostate cancer dedicated database should be present with summarized data of all clinical, imaging, biopsy and pathologic findings. Regarding education, the radiologist should be involved in continuing medical education, courses, workshops and read updates on a routine basis.
Overall there are 3 levels of competence in prostate imaging which the radiologist must undergo. Ultimately, certification specific to prostate imaging should be applied in a standardized internationally accepted method, including all the parameters mentioned above.
In conclusion, reliable mpMRI acquisition, interpretation and reporting require education and training in a favorable environment, eventually leading to standardized certification. In the future, urologist themselves might undergo a part of this standardization process as well.
Speaker(s): Philippe. Puech, Lille (FR)
Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto
at the #EAU17 - March 24-28, 2017- London, England