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Prostate MRI in the UK: a survey of current practice by the British Society of Urogenital Radiology

  • urologyxy
  • 3 days ago
  • 1 min read

Abstract


Objectives

To characterise contemporary UK practice in prostate MRI reporting and pathways, and identify priorities for standardisation.


Methods

Between February and April 2025, a questionnaire was distributed by the British Society of Urogenital Radiology to UK-based consultant radiologists who report prostate MRI. It contained 34 questions, covering 6 domains: demographics; MRI protocols; biopsy; reporting preferences; imaging pathways; and attitudes towards accreditation.


Results

77 radiologists representing 52 NHS Trusts across all nations of the UK responded. Key findings include variable patient preparation for MRI including anti-spasmodic medication (69.2% administering) and instruction related to bowel preparation (13.5%). 100% of Trusts were performing MRI prior to biopsy for suspected cancer; 73.1% using multiparametric MRI. When reporting prostate MRI for suspected cancer, 28.6% document only a PI-RADS score, 27.3% only a Likert score, with 44.1% stating both. The PI-QUAL score is moderately well known (71.4% of respondents) but not in routine use (7.8%). Transperineal prostate biopsy was performed at 88.5% of Trusts, with biopsy more likely to be performed by urologists (98.1% of Trusts) or urology nurses (36.5%) than radiologists (26.9%). Patients with high- or very high-risk prostate cancer undergo variable staging pathways, with university teaching hospitals more likely to offer PSMA PET/CT than other settings (33.3% vs 12.0%, p = 0.023)


Conclusions

This survey shows the current state of UK prostate MRI practice, including universal pre-biopsy MRI. It identifies areas for standardisation, including MRI protocols, scoring systems, and national staging guidelines.


Samuel J Withey, Iztok Caglic, Tristan Barrett, Prostate MRI in the UK: a survey of current practice by the British Society of Urogenital Radiology, British Journal of Radiology, 2025;, tqaf312, https://doi.org/10.1093/bjr/tqaf312

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