Employing a Quality Improvement Program to Optimize mpMRI-Directed Fusion Biopsy
From the first published study in 1982, over 40 years of remarkable efforts have made prostate MRI a pivotal clinical tool in prostate cancer (PCa) management. Today, the role of multiparametric MRI (mpMRI) in focal therapy practice starts from the primary diagnosis with an assessment of patient suitability for the treatment, followed by guiding the biopsy and post-imaging monitoring of the treatment response/recurrence. Given the high diagnostic performance, it has been adopted rapidly, with some guidelines now recommending performing mpMRI before obtaining a biopsy to increase the detection of clinically significant PCa. Three types of MRI-directed biopsies are cognitive-targeted biopsy, MRI-directed fusion biopsy (FB), and in-bore MR-guided biopsy. This chapter aims to provide a practical roadmap for employing a quality improvement (QI) program for MRI-directed FB optimization. We start by providing an institutional multidisciplinary experience in QI regarding MRI-FB, followed by a detailed discussion of each step, related QI opportunities, and common pitfalls.
