Radiography

Feasibility of performing MRI prostate before prostate biopsy in a district general hospital in the UK (2017)

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Type of publication:
Conference abstract

Author(s):
*Phan Y.; *Loh A.; *Anandakumar A.; *Umranikar S.; *Lynn N.

Citation:
Journal of Endourology; Sep 2017; vol. 31, S2

Abstract:
Introduction & Objective: Men with abnormal digital rectal examination or raised PSA usually undergo
transrectal ultrasound (TRUS) prostate biopsies. NICE guidelines do not recommend routine MRI prostate before prostate biopsy unless they have a previous negative prostate biopsy. However, all men with positive prostate biopsies will have MRI prostates. The recent publication of PROMIS (Prostate MR Imaging Study) trial suggests that MRI prostate can reduce unnecessary biopsies by a quarter and can improve detection of clinically significant cancer. In light of this, we would like to determine if performing MRI prostate before biopsy is likely to increase workload in our radiology department in a district general hospital in the UK. Materials and Methods: Patients who underwent TRUS prostate biopsy between 3 Dec 2015 to 28 April 2016 were identified. Their data were analysed retrospectively. 1 year follow-up was chosen to see how many patients would have had MRIs. Results: 173 patients were listed for prostate biopsies but only 158 patients had biopsies with an average age of 69.8 years old (range: 49-88 years old) and an average PSA of 48.1ug/l (range: 0.5-3283.1ug/l). 57 patients had a negative prostate biopsy during this period. 30/57 patients did not have a MRI at all; 12/57 patients had a MRI after biopsy; 1/57 patient had a MRI as an acute setting after biopsy to look for abscesses; and 14/57 patients had a MRI before biopsy. Conclusions: In our study, 30/158 (19.0%) did not have any MRI prostate in 1 year after their first prostate biopsy. However, it is possible that this group of patients will have a MRI prostate in the second year or later. If we were to perform a MRI prostate before TRUS prostate biopsy for all patients, it would increase 19.0% workload for our radiology department.

The impact of the introduction of a palliative Macmillan consultant radiographer at one UK cancer centre (2016)

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Type of publication:
Journal article

Author(s):
Goldfinch R., Allerton R., *Khanduri S., *Pettit L.

Citation:
British Journal of Radiology, 2016, vol./is. 89/1065(no pagination)

Abstract:
Objective: The UK radiotherapy (RT) workforce needs novel strategies to manage increasing demand. The appointment of a palliative RT (PRT) consultant radiographer (CR) offers a potential solution to enhance patient pathways providing timely RT. This article examined the impact of one such appointment. Methods: Two prospective audits were completed 1 year apart. All patients receiving PRT for bone metastases between 01/01/2014-31/03/2014 (Audit 1) and 01/01/2015-31/01/2015 (Audit 2) were included. Data collected included demographics, treatment site, dose, fractionation, treatment indication and professionals who planned the PRT. The patient pathway from decision to treat (DTT) to commencement of PRT was scrutinized. Results: 97 patients were identified for Audit 1 and 87 patients for Audit 2. Demographics were similar. Figures relate to Audit 1 and in brackets Audit 2. Indications for treatment: pain 55% (61%), metastatic spinal cord compression 41% (38%) and other neurological symptoms 4% (1%). The CR independently planned 13% (60%), being supervised for 36% (3%). Consultant clinical oncologists planned 43% (31%), with 7% (6%) planned by specialist registrars (SpRs). The pathway was enhanced in Audit 2, with 85% of patients treated within 14 days compared with 73% of patients treated in Audit 1. Conclusion: A CR has the potential to impact on the patient pathway, enabling quicker times from DTT to treatment. Continued audit of the role is required to ensure that it complements SpR training. Advances in knowledge: Increasing longevity and improved systemic therapies have led to greater numbers of patients living longer with metastatic disease. The appointment of a CR offers a potential solution to the capacity difficulties faced by UK RT services.