The glimpse study: global variation in the quality of multiparametric magnetic resonance imaging of the prostate from the prime trial

You have accessJournal of UrologyCME1 Apr 2023PD22-01 THE GLIMPSE STUDY: GLOBAL VARIATION IN THE QUALITY OF MULTIPARAMETRIC MAGNETIC RESONANCE IMAGING OF THE PROSTATE FROM THE PRIME TRIAL Aqua Asif, Francesco Giganti, Vinson Wai-Shun Chan, Marimo Rossiter, Arjun Nathan, Pramit Khetrapal, Louise Dickinson, Shonit Punwani, Chris Brew-Graves, Alex Freeman, Mark Emberton, Caroline M. Moore, Clare Allen, Veeru Kasivisvanathan, and Prime Quality Improvement Group Aqua AsifAqua Asif More articles by this author , Francesco GigantiFrancesco Giganti More articles by this author , Vinson Wai-Shun ChanVinson Wai-Shun Chan More articles by this author , Marimo RossiterMarimo Rossiter More articles by this author , Arjun NathanArjun Nathan More articles by this author , Pramit KhetrapalPramit Khetrapal More articles by this author , Louise DickinsonLouise Dickinson More articles by this author , Shonit PunwaniShonit Punwani More articles by this author , Chris Brew-GravesChris Brew-Graves More articles by this author , Alex FreemanAlex Freeman More articles by this author , Mark EmbertonMark Emberton More articles by this author , Caroline M. MooreCaroline M. Moore More articles by this author , Clare AllenClare Allen More articles by this author , Veeru KasivisvanathanVeeru Kasivisvanathan More articles by this author , and Prime Quality Improvement Group More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003295.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Multiparametric MRI (mpMRI) is standard-of-care in patients with clinical suspicion of prostate cancer (PCa). However, there is still high variability in MRI quality. We aim to offer the first global 'GLIMPSE' into prostate mpMRI quality variation, analysing data from the PRIME Trial, and to determine whether basic modifications to MRI protocols could optimise diagnostic quality. METHODS: PRIME is a prospective, international, multicentre, level 1-evidence diagnostic study. It aims to recruit 500 men to evaluate whether biparametric MRI is non-inferior to mpMRI in detecting clinically significant PCa. For each scanner, centres were invited to submit 5 consecutive MRI scans of patients with suspected PCa, the detailed MRI protocol, PI-RADS v2.1 scores and pathology results. These were evaluated in consensus by 2 expert radiologists, blinded to the MRI and biopsy results. MRI quality was assessed for each scanner using the PI-QUAL scoring system — a Likert scale using PI-RADS v2.1 recommendations and each MR sequence (DWI, T2-WI and DCE). A PI-QUAL score 5/5 means the scan is of optimal diagnostic quality, using all 3 sequences; 3/5 means at least 2 sequences together are of this, whilst 1/5 means all sequences are below the minimum standard. Feedback was provided for scanners not reaching PI-QUAL 5 to improve MRI quality and centres were invited to resubmit new images using modified protocols for re-evaluation. RESULTS: 66 centres from 22 countries across 5 continents expressed an interest to take part in PRIME, 42 (64%) of which took part in the GLIMPSE study. 391 scans from 71 different scanners were evaluated, 54 (76%) were 3T systems, and 5 (7%) used an endorectal coil. On initial review, 9/71 (13%) scanners scored PI-QUAL 3, 39/71 (55%) scored PI-QUAL 4 and 23/71 (32%) scored PI-QUAL 5. All scanners were of adequate diagnostic quality for T2-WI and DWI sequences, whilst only 58/71 (82%) were for DCE sequences. Recommendations were primarily made for DCE sequences (62%, 44/71), followed by DWI (35%, 25/71) and T2-WI (25%, 18/71). After feedback and modifications, MRI quality increased on final review with 62/71 (87%) of scanners reaching PI-QUAL 5 compared to only 32% at initial review. CONCLUSIONS: The GLIMPSE Study offers the first global overview into prostate MR image quality variation. Initial MRI quality was fair, with room for improvement, particularly with DCE imaging. With basic changes in-line with PI-RADS recommendations, global MRI quality can be easily improved. Source of Funding: The PRIME trial (NCT04571840) is funded by Prostate Cancer UK, The John Black Charitable Foundation, the European Association of Urology Research Foundation, and the Dieckmann Foundation © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e664 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Aqua Asif More articles by this author Francesco Giganti More articles by this author Vinson Wai-Shun Chan More articles by this author Marimo Rossiter More articles by this author Arjun Nathan More articles by this author Pramit Khetrapal More articles by this author Louise Dickinson More articles by this author Shonit Punwani More articles by this author Chris Brew-Graves More articles by this author Alex Freeman More articles by this author Mark Emberton More articles by this author Caroline M. Moore More articles by this author Clare Allen More articles by this author Veeru Kasivisvanathan More articles by this author Prime Quality Improvement Group More articles by this author Expand All Advertisement PDF downloadLoading ...