Vol. 42 (3): 464-471, May – June, 2016
Prostate MRI: a national survey of Urologist’s attitudes and perceptions
Brandon J. Manley 1, John A. Brockman 1, Valary T. Raup 1, Kathryn J. Fowler 2, Gerald L. Andriole 1
1 Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine St. Louis, USA; 2 Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
Introduction: The use of multi-parametric (MP) MRI to diagnose prostate cancer has been the subject of intense research, with many studies showing positive results. The purpose of our study is to better understand the accessibility, role, and perceived accu¬racy of MP-MRI in practice by surveying practicing urologists.
Materials and Methods: Surveys were sent to 7,400 practicing American Urological Association member physicians with a current email address. The survey asked demo¬graphic information and addressed access, accuracy, cost, and role of prostate MRI in clinical practice.
Results: Our survey elicited 276 responses. Respondents felt that limited access and prohibitive cost of MP-MRI limits its use, 72% and 59% respectively. Academic uro¬logists ordered more MP-MRI studies per year than those in private practice (43.3% vs. 21.1%; p<0.001). Urologists who performed more than 30 prostatectomies a year were more likely to feel that an MP-MRI would change their surgical approach (37.5% vs. 19.6%, p-value=0.002). Only 25% of respondents agreed or strongly agreed that MP-MRI should be used in active surveillance. For patients with negative biopsies and elevated PSA, 39% reported MP-MRI to be very useful.
Conclusions: Our study found that MP-MRI use is most prominent among practitioners who are oncology fellowship-trained, practice at academic centers, and perform more than 30 prostatectomies per year. Limited access and prohibitive cost of MP-MRI may limit its utility in practice. Additionally, study participants perceive a lack of accuracy of MP-MRI, which is contrary to the recent literature.
Keywords: Prostate; Magnetic Resonance Imaging; Prostatic Neoplasms