Imaging for prostate cancer defines the extent of disease. Guidelines recommend against imaging low-risk prostate cancer patients with a computed tomography (CT) scan or bone scan due to the low probability of metastasis. We reviewed imaging performed for men diagnosed with low-risk prostate cancer across the Pennsylvania Urologic Regional Collaborative (PURC), a physician-led data sharing and quality improvement collaborative. The data of 10 practices were queried regarding the imaging performed in men diagnosed with prostate cancer from 2015 to 2022. The cohort included 13,122 patients with 3502 (27%) low-risk, 2364 (18%) favorable intermediate-risk, 3585 (27%) unfavorable intermediate-risk, and 3671 (28%) high-risk prostate cancer, based on the AUA guidelines. Amongst the low-risk patients, imaging utilization included pelvic MRI (59.7%), bone scan (17.8%), CT (16.0%), and PET-based imaging (0.5%). Redundant imaging occurred in 1022 patients (29.2%). There was variability among the PURC sites for imaging used in the low-risk patients, and iterative education reduced the need for CT and bone scans. Approximately 15% of low-risk patients had staging imaging performed using either a CT or bone scan, and redundant imaging occurred in almost one-third of men. Such data underscore the need for continued guideline-based education to optimize the stewardship of resources and reduce unnecessary costs to the healthcare system.
Current oncology (Toronto, Ont.). 2024 Aug 20*** epublish ***
Raidizon Mercedes, Dennis Head, Elizabeth Zook, Eric Eidelman, Jeffrey Tomaszewski, Serge Ginzburg, Robert Uzzo, Marc Smaldone, John Danella, Thomas J Guzzo, Daniel Lee, Laurence Belkoff, Jeffrey Walker, Adam Reese, Mihir S Shah, Bruce Jacobs, Jay D Raman
Department of Urology, Penn State College of Medicine, Hershey, PA 17033, USA., Department of Urology, Cooper University Health Care, Camden, NJ 08103, USA., Department of Urology, Einstein Healthcare Network, Philadelphia, PA 19141, USA., Department of Urology, Fox Chase Cancer Center, Philadelphia, PA 19111, USA., Department of Urology, Geisinger Health, Danville, PA 17822, USA., Department of Urology, University of Pennsylvania Health System, Philadelphia, PA 19104, USA., MidLantic Urology, Bala Cynwyd, PA 19008, USA., Department of Urology, Temple University Hospital, Philadelphia, PA 19140, USA., Department of Urology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA., Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA 15219, USA.