Urology department MRI use for Prostate Cancer Diagnosis
Dear West Suffolk 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, 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)
Freedom of Information Request Acknowledgement
Thank you for your request which was received by us on 22nd August 2019.
Under the Freedom of Information (FOI) Act 2000 we are required to provide a response within 20 working days. You should expect to receive a response by 20th September 2019.
We will advise you if we do not hold the information requested or if an exemption applies.
Your request has been given the reference number FOI 19-12295 .
FOI Team
T: 01284 712941 | Ext: 2941
West Suffolk NHS Foundation Trust
Hardwick Lane|Bury St Edmunds|SUFFOLK|IP33 2QZ
Dear Lizzie Ellis
I am writing to confirm that the West Suffolk NHS Foundation Trust has now completed its search for the information which you requested on 22nd August 2019
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):
b. Yes, using T2-weighted, diffusion-weighted (multi-b ADC and high/long b) sequences but not DCE
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? Routine for most
4. What are your eligibility criteria/exclusion criteria for prostate MRI? (please tick all that apply):
a. Age (please provide details) - no fixed age
b. Symptoms (please provide details) - no
c. Life expectancy (please provide details) - greater than 10 years
d. Contra-indications (please provide details) - standards MRI CIs
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) - yes
6. Do you biopsy all PI-RADS or LIKERT 3 scores?
b. No
7. What threshold do you mostly use for ruling men out of biopsy?
e. Varies depending on age
f. Varies depending on other factors (Please provide detail)
8. What percentage of men do you estimate are ruled out of biopsy? - Don’t know
9. Have there been any changes to your prostate MRI capacity in the last year? (please choose all that apply):
c. Agreement to use Dynamic Contrast Enhancement
10. Has the number of radiologists at your trust/health board who report prostate MRI scans changed in the last year?
c. Stayed the same
11. How many radiologists at your trust/health board report at least 250 prostate MRI scans per year? - Cannot answer
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)
The information supplied to you continues to be protected by the Copyright, Designs and Patents Act 1988. You are free to use it for your own purposes, including any non-commercial research and for the purposes of news reporting. Any other reuse, for example commercial publication, would require the permission of the copyright holder.
If you are unhappy with the service you have received in relation to your request and wish to make a complaint or request a review of our decision, you should write to:
Chief Executive
West Suffolk NHS Foundation Trust
Hardwick Lane
Bury St Edmunds
Suffolk IP33 2QZ
If you are not content with the outcome of your complaint, you may request the Information Commissioner’s Office to carry out a review.
Kind regards
Emily Speare
FOI & IG Support Officer
T: 01284 712941 | Ext: 2941
West Suffolk NHS Foundation Trust
Hardwick Lane|Bury St Edmunds|SUFFOLK|IP33 2QZ
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