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National implementation of multi-parametric MRI for prostate cancer detection - recommendations from a UK consensus meeting

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Title: National implementation of multi-parametric MRI for prostate cancer detection - recommendations from a UK consensus meeting
Authors: Brizmohun Appayya, M
Adshead, J
Ahmed, HU
Allen, C
Bainbridge, A
Barrett, T
Giganti, F
Graham, J
Haslam, P
Johnston, EW
Kastner, C
Kirkham, APS
Lipton, A
McNeill, A
Moniz, L
Moore, CM
Nabi, G
Padhani, AR
Parker, C
Patel, A
Pursey, J
Richenberg, J
Staffurth, J
Van der Meulen, J
Walls, D
Punwani, S
Item Type: Journal Article
Abstract: OBJECTIVES: To identify areas of agreement and disagreement in the implementation of multi-parametric MRI (mpMRI) of the prostate in the diagnostic pathway. MATERIALS AND METHODS: Fifteen UK experts in prostate mpMRI and/or prostate cancer management across the UK (involving 9 NHS centres to provide for geographical spread) participated in a consensus meeting following the UCLA-RAND Appropriateness Method, and were moderated by an independent chair. The experts considered 354 items pertaining to who can request an mpMRI, prostate mpMRI protocol, reporting guidelines, training, quality assurance (QA) and patient management based on mpMRI levels of suspicion for cancer. Each item was rated for agreement on a 9-point scale. A panel median score of >/= 7 constituted 'agreement' for an item; for an item to reach 'consensus', a panel majority scoring was required. RESULTS: Consensus was reached on 59% of items (208/354); these were used to provide recommendations for the implementation of prostate mpMRI in the UK. Key findings include prostate mpMRI requests should be made in consultation with the urological team; mpMRI scanners should undergo quality assurance checks to guarantee consistently high diagnostic quality scans; scans should only be reported by trained and experienced radiologists to ensure that men with non-suspicious prostate mpMRI might consider avoiding an immediate biopsy. CONCLUSIONS: Our consensus statements demonstrate a set of criteria that are required for the practical dissemination of consistently high quality prostate mpMRI as a diagnostic test prior to biopsy in men at risk. This article is protected by copyright. All rights reserved.
Issue Date: 1-Jul-2018
Date of Acceptance: 1-Apr-2018
URI: http://hdl.handle.net/10044/1/59175
DOI: https://dx.doi.org/10.1111/bju.14361
ISSN: 1464-4096
Publisher: Wiley
Start Page: 13
End Page: 25
Journal / Book Title: BJU International
Volume: 122
Issue: 1
Copyright Statement: © 2018 The Authors. Published by John Wiley & Sons Ltd on behalf of BJU International. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited
Sponsor/Funder: Wellcome Trust
University College London Hospitals Charity
Funder's Grant Number: 204998/Z/16/Z
1348
Keywords: Science & Technology
Life Sciences & Biomedicine
Urology & Nephrology
consensus methods
multi-parametric MRI
prostate cancer
recommendations
NEGATIVE PREDICTIVE-VALUE
ULTRASOUND-GUIDED BIOPSY
RADS VERSION 2
MULTIPARAMETRIC MRI
RADICAL PROSTATECTOMY
ACTIVE SURVEILLANCE
ANTIGEN DENSITY
DATA SYSTEM
DIAGNOSTIC-ACCURACY
INITIAL BIOPSY
Prostate cancer
1103 Clinical Sciences
Publication Status: Published
Conference Place: England
Online Publication Date: 2018-04-26
Appears in Collections:Division of Surgery
Faculty of Medicine



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