Dear Bedford Hospital NHS Trust,

Prostate Cancer UK undertook a Freedom of Information Act (FOI) request of all Trusts, Health Boards and Health and Social Care Trusts in 2016, and again in 2018, with the aim of achieving a state of the nation overview of the use of mpMRI before biopsy.

We gained an in-depth understanding of the current status of mpMRI before prostate biopsy across the UK. We have used the data to make the case to National Commissioners for implementation support. It has also guided our funding and development of resources that respond to some of the challenges and barriers to implementation that centres told us they faced.

This third and final round of questions is our means of understanding what progress has been made and to identify where we can target our resources and National Commissioners’ support to have maximum impact.

We really appreciate your help with this. Please pass the below on to your urology department for them to complete. If this is not possible we would really appreciate your help to provide as much information as you can.

Yours faithfully,

Lizzie Ellis

1. Do you routinely conduct prostate MRI (bpMRI/mpMRI) scans before first prostate biopsy as part of the initial diagnostic process? (please tick all that apply):

a. Yes, using T2-weighted, diffusion-weighted (multi-b ADC and high/long b) and dynamic contrast enhanced (DCE) sequences
b. Yes, using T2-weighted, diffusion-weighted (multi-b ADC and high/long b) sequences but not DCE
c. No but we refer to another provider (please provide details)
d. No (please provide details)

2. If yes, to 1a: What percentage of men with suspected prostate cancer receive mpMRI before biopsy as part of the initial diagnostic process?

3. If yes, to 1b: What percentage of men with suspected prostate cancer receive bpMRI before biopsy as part of the initial diagnostic process?

4. What are your eligibility criteria/exclusion criteria for prostate MRI? (please tick all that apply):
a. Age (please provide details)
b. Symptoms (please provide details)
c. Life expectancy (please provide details)
d. Contra-indications (please provide details)
e. Other (please provide details)

5. Are you using results from the prostate MRI before biopsy to rule some men out of biopsy as part of the initial diagnostic process? (yes/no)

6. Do you biopsy all PI-RADS or LIKERT 3 scores?
a. Yes
b. No
c. Dependent on patient histology

7. What threshold do you mostly use for ruling men out of biopsy?
a. PI-RADs 3 and above
b. LIKERT 3 and above
c. PI-RADs 4 and above
d. LIKERT 4 and above
e. Varies depending on age (Please provide detail)
f. Varies depending on other factors (Please provide detail)

8. What percentage of men do you estimate are ruled out of biopsy?

9. Have there been any changes to your prostate MRI capacity in the last year? (please choose all that apply):
a. An additional or new MRI scanner
b. Increased MRI scanner slots for prostate
c. Agreement to use Dynamic Contrast Enhancement
d. No longer using Dynamic Contrast Enhancement
e. A scanner/magnet upgrade
f. other (free text)

10. Has the number of radiologists at your trust/health board who report prostate MRI scans changed in the last year?
a. Increased
b. Decreased
c. Stayed the same

11. How many radiologists at your trust/health board report at least 250 prostate MRI scans per year?

12. Which of the following processes do you follow to manage men ruled out of an immediate biopsy, but with a raised PSA?
a. NICE Guidelines: prostate cancer diagnosis and management (NG131)
b. A local protocol (please provide details)
c. Other (please provide details)

FOI, Bedford Hospital NHS Trust

Thank you for contacting the Freedom of Information (FOI).

 

We will ensure that you receive a response as soon as possible.

 

Kind regards,

Bedford Hospital NHS Trust

FOI team

 

FOI, Bedford Hospital NHS Trust

Dear Ms Ellis,

I acknowledge receipt of your request under the Freedom of Information (FOI) Act, and you can expect the Trust’s response on or by 16/09/2019.

Yours sincerely,

IG/FOI Coordinator

Bedford Hospital NHS Trust
Kempston Rd | Bedford | MK42 9DJ

dangos adrannau a ddyfynnir

FOI, Bedford Hospital NHS Trust

Dear Ms Ellis,

 

I write in response to your request under the Freedom of Information (FOI)
Act. 

 

Please see the Trust’s replies below.

 

 

 

1.            Do you routinely conduct prostate MRI (bpMRI/mpMRI) scans
before first prostate biopsy as part of the initial diagnostic process?
(please tick all that apply):

 

a.            Yes, using T2-weighted, diffusion-weighted (multi-b ADC and
high/long b) and dynamic contrast enhanced (DCE) sequences Yes

b.            Yes, using T2-weighted, diffusion-weighted (multi-b ADC and
high/long b) sequences but not DCE

c.             No but we refer to another provider (please provide
details)

d.            No (please provide details)

 

2.            If yes, to 1a: What percentage of men with suspected
prostate cancer receive mpMRI before biopsy as part of the initial
diagnostic process? 95%

 

3.            If yes, to 1b: What percentage of men with suspected
prostate cancer receive bpMRI before biopsy as part of the initial
diagnostic process? N/A

 

4.            What are your eligibility criteria/exclusion criteria for
prostate MRI? (please tick all that apply):

a.            Age (please provide details) 50-75

b.            Symptoms (please provide details) DO NOT DETERMINE THE
DECISION OF DOING MRI

c.             Life expectancy (please provide details) > 10 YEARS

d.            Contra-indications (please provide details) CARDIAC
PACEMAKER (UNSUITABLE), CLAUSTROPHOBIA

e.            Other (please provide details) 2 ELEVATED PSA LEVELS,
ABNORMAL DRE

 

5.            Are you using results from the prostate MRI before biopsy to
rule some men out of biopsy as part of the initial diagnostic process?
(yes/no) Yes

 

6.            Do you biopsy all PI-RADS or LIKERT 3 scores? No

 

 

7.            What threshold do you mostly use for ruling men out of
biopsy?

a.            PI-RADs 3 and above USUALLY YES

b.            LIKERT 3 and above

c.             PI-RADs 4 and above

d.            LIKERT 4 and above

e.            Varies depending on age (Please provide detail)

f.             Varies depending on other factors (Please provide detail)
AGE AND PSA PROFILE, PREVIOUS HISTORY OF BIOPSIES, FAMILY HISTORY.

 

8.            What percentage of men do you estimate are ruled out of
biopsy? 10 – 20%

 

9.            Have there been any changes to your prostate MRI capacity in
the last year? (please choose all that apply):

a.            An additional or new MRI scanner

b.            Increased MRI scanner slots for prostate Yes

c.             Agreement to use Dynamic Contrast Enhancement Yes

d.            No longer using Dynamic Contrast Enhancement

e.            A scanner/magnet upgrade

f.             other (free text)

 

10.          Has the number of radiologists at your trust/health board who
report prostate MRI scans changed in the last year?

a.            Increased Yes

b.            Decreased

c.             Stayed the same

 

11.          How many radiologists at your trust/health board report at
least 250 prostate MRI scans per year? 3

 

12. Which of the following processes do you follow to manage men ruled out
of an immediate biopsy, but with a raised PSA?

a. NICE Guidelines: prostate cancer diagnosis and management (NG131) b. A
local protocol (please provide details) c. Other (please provide details)

FOLLOW NICE GUIDANCE NG131

 

 

 

 

 

This information is provided for your personal use and is the property of
Bedford Hospital NHS Trust and subject to any existing Intellectual
Property and Database Rights.  Any commercial application or use of this
information may be subject to the provisions of the Re-use of Public
Sector Information Regulations 2015 (RPSI).  This means that if you wish
to re-use the information provided for commercial purposes for any reason
you must ask the Trust for permission to do so.

 

I hope that this information is of help to you but if you are not
satisfied with the Trust’s response, or want to complain about the way in
which your request has been handled, you are entitled to request an
internal review.  To do so, please contact Data Protection Officer and
Information Governance Manager [1][email address]
and should your complaint not be upheld you have the right to appeal
against the decision by contacting the Information Commissioner’s Office,
Wycliffe House, Water Lane, Wilmslow SK9 5AF.

 

 

 

Yours sincerely

 

IG/FOI Coordinator

 

Bedford Hospital NHS Trust

Kempston Rd | Bedford | MK42 9DJ

 

 

 

 

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