Enter the “director of prostate imaging” (at least at some centers)


As regular readers are well aware, there has for a while been an increase in the importance of new forms of high quality imaging studies in the diagnosis, work-up, and monitoring of men with prostate cancer (localized, locally advanced, and advanced).

We were therefore very interested to see a recent article by Westphalen et al. in the journal Abdominal Radiology entitled “The Director of Prostate Imaging: advancing care for prostate cancer patients.” The three authors of the paper all hold titles that are inclusive of this priority at well-known academic institutions on the East and the West Coasts. Unfortunately we can only refer readers to the brief abstract of this paper, but we have had the chance to review the entire article.

Here are what (we think) the authors are saying are key priorities of this position (based on their experience to date):

  • Function “as the local expert” on prostate-related radiological imaging.
  • Collaborate with all other relevant clinicians in assuring the appropriate use of prostate imaging within the institution.
  • Take responsibility for “improving clinical care through high-quality imaging and communication”.
  • Drive “shared planning of institutional policies and pathways for imaging men with suspected or biopsy-proven prostate cancer”.
  • Perform, supervise, and collaborate in the implementation of procedures such as MRI-guided and MRI/TRUS fusion-guided biopsies and focal therapy.
  • Work with community physicians in the establishment of referral programs for patients seeking or needing relevant imaging and treatment programs.
  • “Organize baseline and continued training” for radiologists and others who interpret prostate MRI-related data.
  • Assist in the training of residents and fellows.
  • Work with the specialist imaging technologists to ensure consistency and adequacy of image quality to meet developing standards.
  • Provide input and oversight of specific elements of institutional quality improvement initiatives as they relate to prostate imaging.
  • Work directly with patients and the local patient community to “educate and assist patients with questions that pertain to their scans”.
  • Collaborate as a member of “multidisciplinary teams that aim to foster technical developments in acquisition and utilization of prostate MRI” (and probably other forms of imaging too).

From a patient advocacy perspective it seems to us that there are some important issues here for patients and patient advocates to be aware of. They include the following:

  • Find out whether there is a specific person at you nearest major academic medical center who is filling this role (even if he or she doesn’t have this exact title yet).
  • If you are a support group leader, offer him/her the chance to come and speak to your support group.
  • If you are a patient, and you have questions about imaging studies, ask if there is someone at your local institution who is available to consult with (perhaps for a second opinion) on your scans.

The development of this position or its equivalent at every major academic medical center that treats prostate cancer is something the patient community should want to support or encourage. There may also soon be individuals with similar responsibilities in some of the larger community-based medical groups that specialize in the management of prostate cancer.

Editiorial note: The “New” Prostate Cancer InfoLink thanks Dr. Antonio Westphalen of the University of California, San Francisco, for promptly providing us with a PDF copy of the full text of this article for our review.

We also understand that the final draft of the above-mentioned article (to be published by Springer International Publishing AG) is now accessible through eScholarship, the University of California’s open access repository and publishing platform. The full reference for this article is:

Westphalen AC, Margolis DJA, Rosenkrantz AB. The Director of Prostate Imaging: advancing care for prostate cancer patients. Abdom Radiol. 2017; doi:10.1007/s00261-017-1132-5

One Response

  1. At a large urology practice in Denver (TUCC), one urologist is in charge of performing all MRI-guided biopsies to ensure quality. The urologist will eventually train and monitor other urologists at the center.

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