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Prostate Cancer MRI Center Designation (3-29-2023)

Revision History


The ACR Prostate Cancer MRI Center designation is unit-specific. All sites applying for this designation must meet the requirements outlined below, including having active ACR MR Accreditation in the body module on the designated unit(s).

  

Determine Eligibility

A facility is eligible to receive the ACR Prostate Cancer MRI Center designation if it meets the following basic criteria:

  • ACR MR accreditation in the body module

  • Imaging protocol meets minimum technical specifications and includes the use of an external (surface) pelvis phased-array coil

  • Utilization of Prostate Imaging Reporting and Data Systems (PI-RADS)

  • Coordination of prostate biopsy (fusion/in-bore referral)

  • Radiology/Pathology follow-up

  • MR scanner used for MR prostate studies must be 1.5T-3T

  • Personnel qualifications:

    • MR prostate interpreting physicians must all meet the following:

      • Oversight, interpretation and reporting of 150 MR prostate examinations in the last 36 months, or interpretation and reporting of 100 MR prostate examinations in the last 36 months in a supervised situation*

      • Upon renewal, oversight, interpretation and reporting of 100 MR prostate exams in prior 36 months

    • Radiologic technologists must meet the requirements of the MR accreditation program and have supervised experience in MR prostate exams

      • 50 MR prostate exams upon renewal

    • Qualified medical physicist must meet the requirements of the MR accreditation program

The supervising interpreting physician reviews, discusses, and confirms the diagnosis of the physician being supervised. The supervising interpreting physician does not have to be present at the time of initial interpretation. However, the supervising physician must review and, if necessary, correct the final interpretation. Supervision may also be accomplished through a formal course that includes a lecture format in addition to all of the following: 1) a database of previously performed and interpreted cases, 2) an assessment system traceable to the individual participant, and 3) direct feedback regarding the responses. Examples of suitable assessment systems are an audience response system, a viewbox or monitor based program or an individual CDROM or web-based instruction system.


How to Apply

Sites wishing to be an ACR Designated Prostate Cancer MR Center, initial or renewal cycle, will submit an application and testing in the updated accreditation database.

Becoming an ACR Designated Prostate Cancer MR Center will involve 2-steps:

  • Step 1: Submit an online application including information regarding your Prostate Cancer MRI Center characteristics (MR Prostate Supervising Physician and contact person), accredited MR unit information, and associated invoice/fee (see Fees and Payments).

  • Step 2: Submit an online testing packet to include clinical image data forms and 2 MR prostate studies. Volunteers and/or modules are not acceptable. At least one exam must have a prostate gland volume below 60 cc.  Submitted exams must include a PI-RADS 4 or 5 lesion. Cases that have already been treated or performed for recurrence are not eligible.


After completing our review, the ACR will send a confidential report for each unit to the MR prostate supervising physician at the practice site. The report includes evaluation results, defines areas that can be improved, and provides recommendations for the facility.

  

Benefits of Designation

Once Prostate Cancer MRI Center designation has been achieved, the facility will receive a certificate and a URL to an exclusive online marketing kit customized for an ACR-Designated Prostate Cancer MRI Center. This will assist in promoting the designation to patients and referring physicians within the community. The online marketing toolkit materials include the PCMC logo that may be used on the accredited unit, reports, facility letterhead, website, advertising, etc., and customizable items for print and web use.


Facilities meeting the designation requirements will be identified as an ACR Designated Prostate Cancer MRI Center by a symbol on the ACR Accredited Facility Search page.

 

Designation Renewal

The ACR Prostate Cancer MRI Center designation will remain effective for the duration of the unit’s MR accreditation period, as long as the unit maintains ACR MR accreditation of the body module. Renewal of the designation will occur after the renewal of the MR accreditation is complete. Designation renewal requires submission of a new application, fees, clinical data form, and exam submission.

 

Payment Policy and Fees

Payment must be included with the application. For details, please see Fees and Payments. Applications received without payment will not be processed and will be returned if payment is not received within 30 days. Make checks payable to the American College of Radiology and reference your ACR MR modality identification number on the check or stub. Credit card payments using VISA, MasterCard and American Express are accepted.


Fees are nonrefundable and are subject to change.


MRI Exam Specific Parameters- Prostate

  • eADC maps are not acceptable substitutes for ADC maps

  • If high B values are performed offline, a minimum of 3 images are required with slices at the apex, middle and base

Required Sequences

Category A: Pulse Sequence and Image Contrast

Category B: Anatomic Coverage and Imaging Planes

Category C: Spatial Resolution

Multiplanar T2W

  • 2D T2W Fast-Spin echo (FSE) or Turbo-Spin echo (TSE)

  • 3D T2W can be used as an adjunct to 2D

  • FOV: 12-20 cm to encompass the entire prostate and seminal vesicles

  • Should include axial plane (either straight axial to the patient or in an oblique axial plane matching the long axis of the prostate) and a minimum of one additional orthogonal plane (i.e., sagittal and/or coronal)

  • Slice thickness: ≤ 3 mm

  • Gap: 0 mm

  • Pixel area: ≤0.6 mm2

Axial diffusion weighted images (DWI) with apparent diffusion coefficient (ADC) maps

  • Free-breathing spin echo-echo planar imaging (EPI) combined with spectral fat saturation is recommended

  • TE ≤ 90 msec

  • TR ≥ 3000 msec

  • b-values: Low, intermediate and high b-values required for ADC map creation (low b-value 0-100 sec/mm2and intermediate value 800-1000 sec/mm2); additional high b-values image (≥ 1400 sec/mm2 ) should be acquired separately or calculated from images obtained with low and intermediate b-values < 1000 sec/mm2

  • Note: Low, intermediate and high b-value images must be submitted as separate sequences

  • FOV 16-22 cm

  • Axial (same as T2W)

  • Slice thickness: ≤ 4 mm

  • Gap: 0 mm

  • Pixel area: ≤ 10 mm2

Axial pre-contrast and dynamic contrast enhanced (DCE)

  • Must have pre-contrast images

  • T1W gradient echo (GRE)

  • 3D is preferred over 2D

  • Fat suppression and/or subtractions are recommended

  • TE < 5 msec; TR < 100 msec

  • Contrast dose: 0.1 mmol/kg standard Gadolinium-based contrast agent

  • Injection rate: 2-3 ml/sec starting with continuous image data acquisition (should be the same for all exams)

  • FOV: Should encompass the entire prostate gland and seminal vesicles

  • Axial (same as T2W and DWI)

  • Slice thickness: ≤ 3 mm

  • Gap: 0 mm

  • Temporal resolution: ≤ 15 sec

  • Aquisition time: ≥ 2 min

  • Pixel area:  ≤ 4.0 mm2


Revision History for this Article

Date

Section

Description of Revision(s)

11-9-2022

All

Article created; FAQs incorporated; No criteria changes

12-5-2022


Added exam specific parameters table

3-29-2023


Added personnel qualifications


Multiplanar T2W

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