TOPLINE:

A nationwide survey of prostate MRI practices in the UK revealed the universal adoption of pre-biopsy MRI across all NHS trusts, with 73.1% using multiparametric MRI protocols. However, significant variations in staging protocols persisted between university teaching hospitals and other settings.

METHODOLOGY:

• The British Society of Urogenital Radiology conducted a survey between February and April 2025 by including 77 radiologists representing 52 NHS trusts and one teleradiology provider across the UK, with 47 trusts (90.3%) located in England.
• Researchers designed a 34-question survey combining multiple-choice questions, agreement-level statements, and free-text responses.
• The questionnaire covered six domains: individual and centre demographics, MRI protocols, biopsy practice, reporting preferences, imaging pathways, and attitudes towards accreditation.
• Quantitative responses were summarised with descriptive statistics, and subgroup analysis by hospital type was performed using chi-square tests.

TAKEAWAY:

• All 52 NHS trusts have now offered pre-biopsy MRI, with 73.1% using multiparametric MRI and 26.9% using biparametric MRI protocols.
• For the risk assessment of prostate cancer, 28.6% of radiologists used only Prostate Imaging Reporting and Data System scoring, 27.3% used only Likert scoring, and 44.1% used both scores.
• For high-risk prostate cancer staging, 71.2% of trusts used CT with bone scintigraphy, and only 17.3% used prostate-specific membrane antigen (PSMA)-PET/CT.
• PSMA-PET/CT usage was significantly higher in university teaching hospitals than in other settings (33.3% vs 12.0%; P = .023).

IN PRACTICE:

"Understanding variation in practice is critical to inform future national standards and to provide equitable care within the UK," the authors wrote. "This survey…highlights areas of progress since the 2019 Prostate Cancer UK survey, including now universal adoption of pre-biopsy MRI," they added.

"We identify potential areas for standardisation, including MR imaging protocols, use of scoring systems, and national staging guidelines," they concluded.

SOURCE:

This study was led by Samuel J. Withey, MBBS, Department of Radiology, The Royal Marsden NHS Foundation Trust, London, England. It was published online on December 14, 2025, in the British Journal of Radiology.

LIMITATIONS:

The survey relied on a relatively small sample of 77 self-selected radiologists. Participants were not specifically asked which versions of various scoring systems they utilised. Additionally, 28 out of 52 NHS trusts had at least one radiologist reporting who did not attend the prostate multidisciplinary team meetings, potentially affecting service coordination and quality.

DISCLOSURES:

This study did not receive any funding. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.