title: Current practice and access to prostate MR imaging in France.
abstract: OBJECTIVE
  To obtain an overview of the degree of discrepancy between current clinical practice of prostate magnetic resonance imaging (MRI) in France and recommendations.
  
  
  METHODS
  A brief survey was sent to 1229 members of the French society of urology in order to identify their indications of prostate MRI and its impact on patient management. The urologists were asked to answer several questions regarding age, practice modality, prostate MRI examinations (technique, indication before first biopsy, second biopsy, cancer staging, active surveillance, recurrence, focal therapy) and quality of reports.
  
  
  RESULTS
  A total of 445 responses were received (participation rate of 36%). The mean delay for obtaining an appointment for prostate MRI ranged between 15-30 days in 54%. Fifty-four percent of MRI reports contained a PIRADS score and 23% a Likert score. The indications of multiparametric-MRI were tumor detection/location prior to repeat biopsy (90%), cancer staging (85%), management of patients under active surveillance (85%), selection of candidates to focal therapy (63%), tumor detection/location in biopsy naïve patients (53%), detection of local recurrence after radical (51%). Only 119 urologists (28.6%) had access to image fusion (MRI and transrectal ultrasound) and 351 (85.4%) used cognitive fusion. Mostly, targeted biopsies are done by urologists alone (nearly 80%), a very few are done by radiologists (8%) or by the two of them in collaboration (12%).
  
  
  CONCLUSIONS
  The majority of urologists consider that prostate MRI is essential for the management of patients with prostate cancer. Practices are ahead of recommendations particularly before the first biopsy and in active surveillance.
authors.affiliation: Department of radiology, hôpital Tenon, Pitié-Salpétrière hospital, AP-HP, GRC n(o) 5, ONCOTYPE-URO, institut universitaire de cancérologie, UPMC université Paris 06, 83, boulevard de l'Hôpital, 75013 Paris, France. Electronic address: raphaele.renardpenna@aphp.fr.
authors.forename: R
authors.initials: R
authors.lastname: Renard-Penna
authors.affiliation: Hospices civils de Lyon, department of urinary and vascular radiology, hôpital Édouard-Herriot, 69437 Lyon, France; Faculté de médecine Lyon Est, université de Lyon, université Lyon 1, 69003 Lyon, France.
authors.forename: O
authors.initials: O
authors.lastname: Rouvière
authors.affiliation: Department of radiology, Inserm, university de Lille, U1189 - ONCO-THAI - Image assisted laser therapy for oncology, CHU de Lille, 59000 Lille, France.
authors.forename: P
authors.initials: P
authors.lastname: Puech
authors.affiliation: Department of urology, René-Dubos hospital, 95300 Pontoise, France.
authors.forename: C
authors.initials: C
authors.lastname: Borgogno
authors.affiliation: AP-HP, Pitié-Salpétrière hospital, department of biostatistics, public health and medical information, 75013 Paris, France; Sorbonne université, UPMC université-Paris 06 UMR_S1136, Inserm UMR_S 1136, institut Pierre-Louis d'épidémiologie et de Santé publique, 75013 Paris, France.
authors.forename: L
authors.initials: L
authors.lastname: Abbas
authors.affiliation: Department of radiology B, universitary hospital of Strasbourg, Civil hospital, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Roy
authors.affiliation: Department of radiology adults, Brabois hospital, university of Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France.
authors.forename: M
authors.initials: M
authors.lastname: Claudon
authors.affiliation: Department of radiology, hospital Necker, 75015 Paris, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Correas
authors.affiliation: Bourgogne university, academic department of urology, 21000 Dijon, France.
authors.forename: L
authors.initials: L
authors.lastname: Cormier
authors.affiliation: Department of urology, Saint-Louis hospital, Assistance publique-Hôpitaux de Paris, université Paris Diderot, Paris 7, Sorbonne Paris Cité, Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Ploussard
authors.affiliation: AP-HP, HEGP academic department of urology, 75007 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Mejean
authors.affiliation: AP-HP, Pitié-Salpétrière hospital, department of biostatistics, public health and medical information, 75013 Paris, France; Sorbonne université, UPMC université-Paris 06 UMR_S1136, Inserm UMR_S 1136, institut Pierre-Louis d'épidémiologie et de Santé publique, 75013 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Tezenas-du-Montcel
authors.affiliation: Montsouris institute, urology department, 75014 Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Rozet
mesh_terms: D000328:Adult; D001706:Biopsy / Q000706:statistics & numerical data; D019160:Endosonography / Q000706:statistics & numerical data; D005602:France; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D011795:Surveys and Questionnaires; D014850:Waiting Lists
keywords: Magnetic resonance imaging; Prostate cancer; Recommendations