Prostate MRI Practices and PI-RADS Use in China's Mainland: A Nationwide Assessment and Opportunities for Standardization.

Abstract

To investigate the nationwide prevalence, technical standardization, and reporting practices of prostate MRI and Prostate Imaging-Reporting and Data System (PI-RADS) adoption across China's Mainland. A nationwide cross-sectional survey was conducted from May 1 to June 30, 2023. All hospitals with a Department of Radiology in China's Mainland were invited to report their prostate MRI practices for the year 2022. The questionnaire collected information on hospital characteristics, MRI scanner type, scanning protocols, reporting formats, and examination volume. Hospitals were categorized into high- and low-volume institutions based on the 75th percentile of annual prostate MRI examinations. Statistical analyses were performed using the Mann-Whitney U test, χ² test, or Fisher's exact test, as appropriate. Of the 9,070 hospitals invited, 4,620 were eligible hospitals performing prostate MRI, with 3,919 (84.8%) completed the survey. Most were public, general, and tertiary-level hospitals. The majority used 1.5-T scanners (61.2%) and adopted both biparametric and multiparametric MRI (mpMRI) protocols (60.2%). However, only 58.7% included high b-value DWI, and 55.3% used unstructured reporting formats. Hospitals with higher annual prostate MRI volumes were more likely to use 3.0-T scanners, perform multiparametric MRI, include essential sequences, and adopt PI-RADS reporting. Factors significantly associated with PI-RADS usage included hospital level, economic zone, MRI scanner type, scanning protocol, and examination volume (all P < .05). This nationwide survey reveals substantial variability in prostate MRI practices and limited standardization in PI-RADS implementation across China's Mainland, which highlights the need for national quality control efforts to standardize prostate MRI scanning and reporting and improve diagnostic consistency for prostate cancer.