Picture Perfect: The Status of Image Quality in Prostate <scp>MRI</scp>
Alexandre Woernle, Cameron Englman, Louise Dickinson, Alex Kirkham, Shonit Punwani, Aiman Haider, Alex Freeman, Veeru Kasivisivanathan, Mark Emberton, John Hines, Caroline M. Moore, Clare Allen, Francesco Giganti
Abstract
Magnetic resonance imaging is the gold standard imaging modality for the diagnosis of prostate cancer (PCa). Image quality is a fundamental prerequisite for the ability to detect clinically significant disease. In this critical review, we separate the issue of image quality into quality improvement and quality assessment. Beginning with the evolution of technical recommendations for scan acquisition, we investigate the role of patient preparation, scanner factors, and more advanced sequences, including those featuring Artificial Intelligence (AI), in determining image quality. As means of quality appraisal, the published literature on scoring systems (including the Prostate Imaging Quality score), is evaluated. Finally, the application of AI and teaching courses as ways to facilitate quality assessment are discussed, encouraging the implementation of future image quality initiatives along the PCa diagnostic and monitoring pathway. EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 3.