Prostate MRI quality improvement: a Roadmap from the ESUR Prostate MRI Working Group.
Authors
Affiliations (29)
Affiliations (29)
- University Medical Imaging Toronto, Joint Department of Medical Imaging (University Health Network/Sinai Health System/Women's College Hospital) and Department of Medical Imaging, University of Toronto, Toronto, Canada.
- Department of Medical Imaging, Andros Clinics, Arnhem, The Netherlands.
- Department of Radiology, University College London Hospitals NHS Foundation Trust (UCLH), London, UK.
- Department of Radiology, Hospital Israelita Albert Einstein, São Paulo, Brazil.
- Department of Radiology, Affidea Poland, Warsaw, Poland.
- Department of Nuclear Medicine, Military Institute of Medicine-National Research Institute, Warsaw, Poland.
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
- Institute of Radiology, Department of Medicine (DMED), University of Udine, Udine, Italy.
- University Hospital Santa Maria della Misericordia, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy.
- Department of Radiology, Duke University School of Medicine, Durham, NC, USA.
- Duke Cancer Institute, Center for Prostate & Urologic Cancers, Durham, NC, USA.
- Department of Radiology, Capio S:t Göran's Hospital, Stockholm, Sweden.
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
- Department of Radiology, Community Hospital Hall in Tirol (Tirol Kliniken), Hall in Tirol, Austria.
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria.
- Department of Radiology, Kantonsspital Graubünden, Chur, Switzerland.
- Department of Radiology, Unidade Local de Saúde do Algarve (ULS Algarve), Faro, Portugal.
- Department of Radiology, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark.
- Department of Radiology, CHU Lille (Lille University Hospital), Lille, France.
- University of Lille, Lille, France.
- Imaging Institute, Abdominal Imaging Section and Department of Nuclear Medicine, Diagnostics Institute, Cleveland Clinic, Cleveland, OH, USA.
- Departments of Urology and Colorectal Surgery, Cleveland Clinic, Cleveland, OH, USA.
- Department of Clinical and Interventional Radiology, University Medical Center Göttingen (UMG), Göttingen, Germany.
- Department of Diagnostic and Interventional Radiology, Tübingen University Hospital, Eberhard Karls University Tübingen, Tübingen, Germany.
- Department of Radiology, Netherlands Cancer Institute (NKI), Amsterdam, The Netherlands.
- Department of Radiology and Nuclear Medicine, Ghent University Hospital (UZ Gent), Ghent, Belgium.
- Department of Imaging, University Hospitals Sussex NHS Foundation Trust, Brighton and Sussex Medical School, Brighton, UK.
- Department of Radiology, University College London Hospitals NHS Foundation Trust (UCLH), London, UK. [email protected].
- Division of Surgery & Interventional Science, University College London (UCL), London, UK. [email protected].
Abstract
Prostate magnetic resonance imaging (MRI) has become a crucial tool in diagnosing and managing prostate cancer, mainly by helping to avoid unnecessary biopsies and enhancing the detection of clinically significant disease. However, its clinical usefulness is often limited by wide variation in how images are acquired, interpreted, and reported worldwide. This inconsistency affects diagnostic accuracy and patient outcomes. In response, the Quality Improvement Subgroup of the European Society of Urogenital Radiology (ESUR) Prostate MRI Working Group has created a practical, three-step quality-improvement framework aimed at standardising and improving prostate MRI practices. This framework consists of: Step 1: 'Build it right', establishing a foundation of technical excellence through adherence to the Prostate Imaging Reporting and Data System (PI-RADS) technical standards, objective quality assessment using the Prostate Imaging Quality (PI-QUAL) score, and systematic artefact reduction. Step 2: 'See it right', emphasising interpretive excellence via structured training, institutional quality assurance metrics, and multidisciplinary collaboration. Step 3: 'Improve and innovate', promoting continual refinement through emerging technologies such as AI-driven assessment, deep learning reconstruction, and remote supervision. By incorporating this structured approach into daily practice, this framework aims to ensure that prostate MRI consistently fulfils its promise of accurate, reproducible, and patient-centred care. A coordinated effort towards international implementation, benchmarking, and outcome-based validation represents the next critical step to maximise global impact. KEY POINTS: Question Wide variation in prostate MRI acquisition, image quality, and reporting undermines diagnostic accuracy. A structured roadmap is needed to ensure consistent quality and reproducible practice. Findings The ESUR Prostate MRI Working Group outlines a three-step framework - 'Build it right', 'See it right', 'Improve and innovate' - to standardise acquisition, interpretation, and quality assurance. Clinical relevance Applying this roadmap in clinical practice aims to enhance diagnostic confidence and promote consistent, high-quality prostate cancer care across diverse healthcare settings.