Urology department MRI use for Prostate Cancer Diagnosis

The request was successful.

Dear East Suffolk and North Essex 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)

FOI Requests CGH, East Suffolk and North Essex NHS Foundation Trust

Please be advised that we have received your request for information.

From 1st July 2018, Ipswich and Colchester Hospitals merged to become East Suffolk and North Essex NHS Foundation Trust. Therefore, unless otherwise specified, responses are on behalf of East Suffolk and North Essex NHS Foundation Trust.

Your reference number is 5921

We shall deal with your request in accordance with the Trust's Freedom of Information Act 2000 procedures.

In the meantime, if you have any queries, please do not hesitate to contact us. Please direct any responses to the address supplied or email [East Suffolk and North Essex NHS Foundation Trust request email]

Kind regards,

Ben Plant
Freedom of Information Team
East Suffolk and North Essex NHS Foundation Trust

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FOI Requests CGH, East Suffolk and North Essex NHS Foundation Trust

From 1^st July 2018, Ipswich and Colchester Hospitals merged to become
East Suffolk and North Essex NHS Foundation Trust. Therefore, unless
otherwise specified, responses are on behalf of East Suffolk and North
Essex NHS Foundation Trust.

 

Thank you for your recent enquiry regarding information held by the East
Suffolk and North Essex NHS Foundation Trust:

 

Your enquiry has been dealt with in accordance with the Trust’s Freedom of
Information Act 2000 Policy and Procedures. We are pleased to enclose the
information you requested:

 

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.

 

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?

N/A

 

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

100% of men below 75 years of age

 

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

 

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?

Information not held

 

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?

Information not held

 

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)

 

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Amy Witham

Freedom of Information Team

East Suffolk and North Essex NHS Foundation Trust

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