Assessment of the compliance with minimum acceptable technical parameters proposed by PI-RADS v2 guidelines in multiparametric prostate MRI acquisition in tertiary referral hospitals in the Republic of Turkey.

PURPOSE: Although the clinical use of multiparametric prostate magnetic resonance imaging (mpMRI) is increasing, the adherence to parameters for mpMRI, which had been described in the Prostate Imaging-Reporting and Data System version 2 (PI-RADS v2) for an optimum image acquisition is unknown. In this paper, we aimed to determine the compliance with the minimum acceptable technical parameters for prostate mpMRI defined by PI-RADS v2 in tertiary care centers in Turkey.
METHODS: We sent a survey to all radiology departments of tertiary referral hospitals in Turkey (n=120) to evaluate their adherence to PI-RADS v2 technical specifications. Statistical analysis was performed using chi-square, Fisher exact, ANOVA, and the Student t tests. The cutoff values for image acquisition times were also determined with receiver operating characteristics (ROC) analysis. P values <0.05 were considered statistically significant.
RESULTS: One hundred and eleven clinics responded to our survey (response rate, 92.5%). Prostate MRI was reported to be performed in 61 centers, of which 26 (42.6%) used 3 T (Tesla) scanner while 35 (57.4%) used 1.5 T. The adherence to slice thickness, in-plane phase and frequency resolutions on T2-weighted imaging were 68.9%, 41%, and 9.8%, respectively. The adherence to the same parameters on diffusion-weighted imaging (DWI) were higher compared with T2-weighted imaging (85.2%, 62.3%, and 78.7%, respectively). In comparative analysis, the adherence to slice thickness, field of view (FOV) and in-plane phase resolution on T2-weighted imaging were higher for 3 T compared with 1.5 T scanners (P = 0.004, P = 0.041, and P = 0.001, respectively). T2-weighted imaging acquisition time was significantly longer for the centers that adhered to FOV (P = 0.034) and in-plane T2-weighted imaging phase resolution (P = 0.028). The DWI scan time was significantly longer when they adhered to DWI-FOV (P = 0.014) and b value ≥1400 s/mm2 (P = 0.008). The calculated cutoff of scan times were 220 s in T2-weighted imaging and 312 s in DWI to ensure the compliance with voxel sizes and b value criteria.
CONCLUSION: The tertiary referral centers in Turkey did not meet majority of the technical specifications of PI-RADS v2 during prostate MRI acquisition. Awareness to the minimum acceptable technical parameters of mpMRI should be increased to potentially improve the quality of prostate cancer imaging.