Urology department MRI use for Prostate Cancer Diagnosis
Dear Basildon and Thurrock University Hospitals 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)
Dear Ms Ellis,
Freedom of Information Act Request Acknowledgment
Thank you for contacting the Freedom of Information Office at Basildon and Thurrock University Hospitals NHS Foundation Trust. We confirm that we have received your correspondence.
Your request below is being considered and you will receive a response within the statutory timescale of 20 working days following the date on which the request was received, as defined by the Act, subject to the information not being covered by an exemption or containing reference to a third party.
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If you have any further queries or concerns then please do not hesitate to contact us.
With best regards,
Alan Larn.
Alan Larn | communications officer (Freedom of Information) |
Communications Department
Basildon and Thurrock University Hospitals NHS Foundation Trust | Nethermayne | Essex | SS16 5NL
01268 524900 ext 2992
[Basildon and Thurrock University Hospitals NHS Foundation Trust request email]
Dear FOI,
Further to our Freedom of Information request of 16th 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 sincerely,
Lizzie Ellis
Dear Ms Ellis,
I confirm that the trust has not yet sent you its response to the request below, for which I apologise on behalf of the trust.
I have pursued the request and will contact you as soon as I receive the requested information.
With best regards and apologies once again,
Alan Larn.
Alan Larn | communications officer (Freedom of Information) |
Communications Department
Basildon and Thurrock University Hospitals NHS Foundation Trust | Nethermayne | Essex | SS16 5NL
01268 524900 ext 2992
[Basildon and Thurrock University Hospitals NHS Foundation Trust request email]
Dear Ms Ellis,
Thank you for your Freedom of Information request dated 16 August 2019, which has been handled under the Freedom of Information Act 2000 (FOIA).
Your request and our response are as follows:
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):
Response: a. Yes, using T2-weighted, diffusion-weighted (multi-b ADC and high/long b) and dynamic contrast enhanced (DCE) sequences
2. If yes, to 1a: What percentage of men with suspected prostate cancer receive mpMRI before biopsy as part of the initial diagnostic process?
Response: The percentage is not recorded, but almost all.
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):
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?
7. What threshold do you mostly use for ruling men out of biopsy?
8. What percentage of men do you estimate are ruled out of biopsy?
Response 4 to 8: Practice varies amongst consultant urologists, on the basis of discussions within the LMDT (multidisciplinary team). Consultants have their own views and broadly follow the pathway designed by Southend Hospital.
9. Have there been any changes to your prostate MRI capacity in the last year? (please choose all that apply):
Response: 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?
Response: c. Stayed the same
11. How many radiologists at your trust/health board report at least 250 prostate MRI scans per year?
Response: None.
12. Which of the following processes do you follow to manage men ruled out of an immediate biopsy, but with a raised PSA?
Response: a. NICE Guidelines: prostate cancer diagnosis and management (NG131)
I hope that the response that the Trust has provided is satisfactory. However, if you are dissatisfied with the way in which your Freedom of Information request has been dealt with you can request an internal review. Please email [email address] within 40 working days with clarification of what you would like to be reviewed. We will aim to provide a review response within 20 working days.
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Kind regards,
Alan Larn.
Alan Larn | communications officer (Freedom of Information) | Communications Department Basildon and Thurrock University Hospitals NHS Foundation Trust | Nethermayne | Essex | SS16 5NL
01268 524900 ext 2992
[Basildon and Thurrock University Hospitals NHS Foundation Trust request email]
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