Diagnostic data on an MRI technique for men with suspected prostate cancer
Dear The Royal Marsden NHS Foundation 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 with the aim of achieving a state of the nation overview of the use of mpMRI before biopsy.
With a 100% completion rate, 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 second 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. Your help with this, is really appreciated.
To make responding easier we have created an automated means for you to provide us with the data we are requesting. Please follow this link: https://www.surveymonkey.com/r/VT3L2TS
Alternatively you can manually fill in the answers below and return them to us.
If you have any questions regarding this FOI request please contact Haddi Browne, Impact and Quality Officer on 020 3310 7214 or on email: [email address]
1. Please tell us which Trust, Health Board or Health and Social Care Trust you are responding on behalf of?
2. What percentage of men receive mpMRI before biopsy as part of the initial diagnostic process using T2-weighted, diffusion-weighted (multi-b ADC and high/long b) and dynamic contrast enhanced (DCE) sequences?
__________________________________________________________________________
3. What are your eligibility criteria/exclusion criteria for men to receive pre-biopsy mpMRI?
___________________________________________________________________________
___________________________________________________________________________
4. Are you using mpMRI before biopsy to rule some men out of biopsy as part of the initial diagnostic process?
_________________________________________________________________________
5. What mpMRI scores and/or other clinical factors are used to rule men out of biopsy?
__________________________________________________________________________
6. Do you intend to use mpMRI to rule men out of biopsy in the future?
__________________________________________________________________________
7. How many men annually are referred
(Please provide corresponding numbers)
a) On suspicion of prostate cancer? _________________
b) Eligible for mpMRI? __________________
c) Scanned? _________________
d) Biopsied? _________________
8. If you are unable to provide numbers for question 6, please estimate the percentage of all men referred for b, c and d.
b) Eligible for mpMRI? _______________
c) Scanned? _______________________
d) Biopsied? _______________________
9. Do you carry out targeted biopsies in men with mpMRI lesions in addition to systematic biopsies?
(Please indicate with a X below)
______ Yes – cognitive/visual estimation
______ Yes – image-fusion
______ No – systematic only
If No, what are the reasons for not carrying this out? (eg. expertise, equipment, don’t believe it makes a difference)
__________________________________________________________________________________
10. If you do not currently carry out targeted biopsies, but wish to in the future, what are the current barriers to doing so?
(Please indicate with a X below)
_____Expertise
_____Image-fusion equipment
_____Time factor
_____Other
11. Please indicate the number of uroradiologists undertaking prostate MRI
__________________________________________________________________
12. How many scanners do you have available for mpMRI before biopsy? w
____ 0
____ 1-2
____ 3-4
____ +5
Has this increased in the last 12 months?
_______________________________________________________________________
13. What percentage of scanner time is dedicated to mpMRI before biopsy?
_______________________________________________________________________
Thank you for taking the time to complete this FOI request.
Yours faithfully,
Haddi Browne
Dear Ms Browne,
Thank you for your Freedom of Information request (our ref 3517). We will aim to respond within 20 working days.
Many Thanks
Jordan Andrew
Corporate Governance Officer
Corporate Governance
The Royal Marsden NHS Trust
Dear Ms Browne,
Thank you for your Freedom of Information request (our ref 3517). Please
see our response below.
1. Please tell us which Trust, Health Board or Health and Social Care
Trust you are responding on behalf of?
The Royal Marsden NHS Foundation Trust
2. What percentage of men receive mpMRI before biopsy as part of the
initial diagnostic process using T2-weighted, diffusion-weighted (multi-b
ADC and high/long b) and dynamic contrast enhanced (DCE) sequences?
All patients where this is not contraindicated.
3. What are your eligibility criteria/exclusion criteria for men to
receive pre-biopsy mpMRI?
Please see our response to question 2.
4. Are you using mpMRI before biopsy to rule some men out of biopsy as
part of the initial diagnostic process?
Yes
5. What mpMRI scores and/or other clinical factors are used to rule men
out of biopsy?
PI-RAD, co-morbidity, performance status, LUTS assessment
6. Do you intend to use mpMRI to rule men out of biopsy in the future?
Please note that the Trust already implements this.
7. How many men annually are referred
(Please provide corresponding numbers)
a) On suspicion of prostate cancer? _________________
b) Eligible for mpMRI? __________________
c) Scanned? _________________
d) Biopsied? _________________
Please see our response to question 8.
8. If you are unable to provide numbers for question 7, please estimate
the percentage of all men referred for b, c and d.
b) Eligible for mpMRI? __90%_____________
c) Scanned? ________90%_______________
d) Biopsied? _________60%______________
9. Do you carry out targeted biopsies in men with mpMRI lesions in
addition to systematic biopsies?
Yes – image-fusion
10. If you do not currently carry out targeted biopsies, but wish to in
the future, what are the current barriers to doing so?
(Please indicate with a X below)
_____Expertise
_____Image-fusion equipment
_____Time factor
_____Other
Please see our response to question 9.
11. Please indicate the number of uroradiologists undertaking prostate MRI
Four dedicated oncology radiologists with a special interest in prostate.
12a. How many scanners do you have available for mpMRI before biopsy? w
____ 0 ____ 1-2 ____ 3-4 ____ +5
Please note we have 5 scanners across two sites but we only have two
dedicated fast track slots pre biopsy per week on one site. We undertake a
large amount of active surveillance, on treatment and recurrence work as
we are an oncology centre. Some new patients may not have had a biopsy but
we do not reserve slots for them as they tend to be referred for urgent
staging, or have had imaging done elsewhere that needs to be repeated.
12b. Has this increased in the last 12 months?
No – but we do anticipate an extra NHS scanner in 2019.
13. What percentage of scanner time is dedicated to mpMRI before biopsy?
We save two slots per week on our Chelsea site – so about 2 hours per week
for fast track work. We do not have capacity for a fast track service so
this is being done locally for example Epsom and St Helier hold Prostate
clinics and the patients are scanned at Epsom, not in this centre.
If you are dissatisfied with this response and wish to appeal then please
let me know by writing to:
Corporate Governance
The Royal Marsden
Fulham Road
London
SW3 6JJ
Or alternatively, you can email: [1][The Royal Marsden NHS Foundation Trust request email]
Any complaints will be dealt with through our Internal Review procedure.
If you are still not satisfied following the Internal Review, you have a
right to appeal to the Information Commissioner using the following
contact details:
Information Commissioner's Office
Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF
Telephone: 01625 545 700
Kind Regards,
Jordan Andrew
Corporate Governance Officer
Corporate Governance
The Royal Marsden NHS Trust
[2]Description: cid:image001.png@01D3A4B9.5F4D41C0
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