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Erschienen in: Abdominal Radiology 9/2018

22.02.2018

Long-distance longitudinal prostate MRI quality assurance: from startup to 12 months

verfasst von: Nicole E. Curci, Patrick Gartland, Prasad R. Shankar, Jeffrey S. Montgomery, David C. Miller, Arvin K. George, Matthew S. Davenport

Erschienen in: Abdominal Radiology | Ausgabe 9/2018

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Abstract

Purpose

To evaluate a 12-month long-distance prostate MRI quality assurance (QA) program.

Methods

The need for IRB approval was waived for this prospective longitudinal QA effort. One academic institution experienced with prostate MRI [~ 1000 examinations/year (Site 2)] partnered with a private institution 240 miles away that was starting a new prostate MRI program (Site 1). Site 1 performed all examinations (N = 249). Four radiologists at Site 1 created finalized reports, then sent images and reports to Site 2 for review on a rolling basis. One radiologist at Site 2 reviewed findings and exam quality and discussed results by phone (~ 2–10 minutes/MRI). In months 1–6 all examinations were reviewed. In months 7–12 only PI-RADS ≤ 2 and ‘difficult’ cases were reviewed. Repeatability was assessed with intra-class correlation (ICC). ‘Clinically significant cancer’ was Gleason ≥ 7.

Results

Image quality significantly (p < 0.001) improved after the first three months. Inter-rater agreement also improved in months 3–4 [ICC: 0.849 (95% CI 0.744–0.913)] and 5–6 [ICC: 0.768 (95% CI 0.619–0.864)] compared to months 1–2 [ICC: 0.621 (95% CI 0.436–0.756)]. PI-RADS ≤ 2 examinations were reclassified PI-RADS ≥ 3 in 19% (30/162); of these, 23 had post-MRI histology and 57% (13/23) had clinically significant cancer (5.2% of 249). False-negative examinations [N = 18 (PI-RADS ≤ 2 and Gleason ≥ 7)] were more common at Site 1 during months 1–6 [9% (14/160) vs. 4% (4/89)]. Positive predictive values for PI-RADS ≥ 3 were similar.

Conclusion

Remote quality assurance of prostate MRI is feasible and useful, enabling new programs to gain durable skills with minimal risk to patients.
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Metadaten
Titel
Long-distance longitudinal prostate MRI quality assurance: from startup to 12 months
verfasst von
Nicole E. Curci
Patrick Gartland
Prasad R. Shankar
Jeffrey S. Montgomery
David C. Miller
Arvin K. George
Matthew S. Davenport
Publikationsdatum
22.02.2018
Verlag
Springer US
Erschienen in
Abdominal Radiology / Ausgabe 9/2018
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-018-1481-8

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