Urology department MRI use for Prostate Cancer Diagnosis

Lizzie Ellis made this Freedom of Information request to Mid Essex Hospital Services NHS Trust as part of a batch sent to 16 authorities

This request has been closed to new correspondence. Contact us if you think it should be reopened.

The request was successful.

Dear Mid Essex Hospital Services 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)

MEHT FOI (RQ8) Mid Essex Hospital, Mid Essex Hospital Services NHS Trust

 Dear Requester

 

Thank you for your email and request for information under the Freedom of
Information Act.

Your request has been acknowledged.  Normal Freedom of Information
timescales apply from receipt of your request (20 working days) into this
MEHT FOI mailbox.

We look forward to dealing with your request.  Please
contact [1][Mid Essex Hospital Services NHS Trust request email] with any queries.

With kind regards
Rebecca Pascoe Youell
Public Information Manager

 

Information in this message may contain confidential and privileged
information. If you are not the intended recipient please accept our
apologies; please do not disclose, copy or distribute information in this
e-mail or take any action in reliance on its contents: to do so is
strictly prohibited and may be unlawful. Please inform us that this
message has gone astray before deleting it. Content of emails received by
this Trust will be subject to disclosure under the Freedom of Information
Act 2000. Unless the information is legally exempt from disclosure,
confidentiality of this e-mail and your reply cannot be guaranteed. Thank
you for your co-operation.

References

Visible links
1. mailto:[Mid Essex Hospital Services NHS Trust request email]

Dear Mid Essex Hospital Services NHS Trust,

Further to our Freedom of Information request of 20th August 2019, we have received a large number of responses, however, we are still awaiting a response from your Trust. Please provide a response as soon as possible as the deadline has passed.
Please let me know if you are having any problems completing the request.

Yours faithfully,

Lizzie Ellis

Struthers Karen (RQ8) Mid Essex Hospital, Mid Essex Hospital Services NHS Trust

1 Attachment

Good Morning

 

Thank you for your request for information under the Freedom of
Information Act.

 

Please accept our sincere apologies for the delay you have incurred in
receiving this response.

 

Our responses to your questions are shown below in red.

 

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 – usually.  

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? The
majority.

 

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) <73

b. Symptoms (please provide details) abnormal DRE/elevated PSA

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

d. Contra-indications (please provide details) Pacemaker/certain metals
in-situ

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 if
results are available

 

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) PSA
level/whether clinical diagnosis can be obtained by DRE/PSA /
co-morbidities

 

8. What percentage of men do you estimate are ruled out of biopsy? 20-30%

 

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 – Yes a new scanner was installed in
September 2019

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 – A new scanner replaced the old scanner of 15
years and this was therefore an upgrade in terms of the latest technology

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? Two

 

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)
Both a and b

 

If you are not satisfied with this response you may request an independent
internal review by a senior member of the Trust staff who has had no involvement
in dealing with your request. We aim to deal with FOI appeals within 20 days of
receipt. Emails should be clearly marked ‘Internal Review ' and sent to
[1][email address] Should you remain dissatisfied after this internal review,
you will have a right of complaint to the Information Commissioner. Further
information is available at: Information Commissioner's Office Wycliffe House
Water Lane Wilmslow Cheshire SK95AF Telephone: 01625 545 700 -
[2]www.informationcommissioner.gov.uk

 

If you have any other queries please do not hesitate to contact me again.

 

Karen

 

Karen Struthers

Executive Assistant to Trust Secretary/Director of Strategy

 

Mid Essex Hospital Services NHS Trust

Broomfield Hospital | Chelmsford | Essex | CM1 7ET

Tel: 01245 514442 ext 4442 | Email: [3][email address]

Working Hours: Mon- Thurs 0730 to 1600 / Fri 0730 - 1300

 

Visit our website: [4]www.meht.nhs.uk | Follow us on social media:
@Broomfieldnhs

 

[5]Patients First

 

 

Information in this message may contain confidential and privileged
information. If you are not the intended recipient please accept our
apologies; please do not disclose, copy or distribute information in this
e-mail or take any action in reliance on its contents: to do so is
strictly prohibited and may be unlawful. Please inform us that this
message has gone astray before deleting it. Content of emails received by
this Trust will be subject to disclosure under the Freedom of Information
Act 2000. Unless the information is legally exempt from disclosure,
confidentiality of this e-mail and your reply cannot be guaranteed. Thank
you for your co-operation.

References

Visible links
1. mailto:[email address]
2. http://www.informationcommissioner.gov.uk/
3. mailto:[email address]
4. http://www.meht.nhs.uk/