Improving prostate MRI quality assessment across diverse evaluators and institutional practice through a PI-QUAL v2 lecture: a pilot study
Abstract
Objective: To evaluate the impact of a prostate imaging quality (PI-QUAL) v2 lecture on the accuracy and inter-reader agreement of prostate MRI image-quality assessment among radiologists and technologists from diverse professional backgrounds and institutions, and to evaluate its role in institutional-level quality improvement through a quality control (QC) process.
Materials and methods: Ten participants (five radiologists and five technologists) from five different hospitals independently evaluated 15 prostate MRIs before and after a standardized PI-QUAL v2 lecture. Reference scores were established by two experienced radiologists. Concordance with reference was assessed using accuracy and balanced accuracy. Inter-reader agreement was measured using percent agreement (PA) and Gwet’s AC1. Subgroup analyses were conducted based on participant characteristics. For the quality assurance and QC (QA/QC), each center submitted 15 prostate MRIs before and after the lecture. Image quality was evaluated centrally to assess institutional improvement.
Results: Overall accuracy increased from 66.7% to 76.7%, and balanced accuracy increased from 62.9% to 84.2%; the mixed-effects model indicated significantly higher post-lecture accuracy ( p = 0.038). Accuracy was also higher across all subgroups. Inter-reader agreement improved from PA 57.6% to 72.6% and Gwet’s AC1 from 0.214 to 0.466. Through the QA/QC process, three centers initially failed to meet PI-QUAL v2 technical criteria. After feedback, all post-intervention scans achieved PI-QUAL v2 scores > 1.
Conclusion: A structured PI-QUAL v2 lecture improved both the accuracy and inter-reader agreement of prostate MRI image-quality assessments among diverse evaluators. Incorporating QA/QC further enhanced institutional image quality. PI-QUAL v2 training is a feasible strategy for standardizing prostate MRI quality.
Key Points: Question Does a structured PI-QUAL v2 lecture for radiologists and technologists improve prostate MRI quality assessment performance and institutional imaging practice across institutions?
Findings PI-QUAL v2 training improved accuracy (66.7% to 76.7%) and inter-reader agreement in prostate MRI quality assessment, while QA/QC feedback enhanced institutional imaging quality.
Clinical relevance statement Structured PI-QUAL v2 education combined with quality assurance and quality control feedback improves evaluator consistency and institutional prostate MRI quality, facilitating standardized image-quality assessment and broader implementation of high-quality prostate MRI in clinical radiology.
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BibTeX
@article{xu2026improving,
title = {{Improving prostate MRI quality assessment across diverse evaluators and institutional practice through a PI-QUAL v2 lecture: a pilot study}},
author = {Lili Xu and Xu Wang and Yitao Liu and Kai Li and Xiaoxiao Zhang and Hailong Zhou and Gumuyang Zhang and Jianfeng Yang and Hongxia Ni and Liming Yang and Yifeng Zheng and Dong Liu and Guoqing Xiao and Zufeng Ge and Tianlu Feng and Yu Feng and Clare Allen and Caroline M. Moore and Francesco Giganti and Hao Sun and Lei Shi},
journal = {Insights into Imaging},
year = {2026},
month = oct,
doi = {10.1186/s13244-026-02450-x},
url = {https://link.springer.com/article/10.1186/s13244-026-02450-x},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Improving prostate MRI quality assessment across diverse evaluators and institutional practice through a PI-QUAL v2 lecture: a pilot study
AU - Lili Xu
AU - Xu Wang
AU - Yitao Liu
AU - Kai Li
AU - Xiaoxiao Zhang
AU - Hailong Zhou
AU - Gumuyang Zhang
AU - Jianfeng Yang
AU - Hongxia Ni
AU - Liming Yang
AU - Yifeng Zheng
AU - Dong Liu
AU - Guoqing Xiao
AU - Zufeng Ge
AU - Tianlu Feng
AU - Yu Feng
AU - Clare Allen
AU - Caroline M. Moore
AU - Francesco Giganti
AU - Hao Sun
AU - Lei Shi
PY - 2026
DA - 2026/10/29
JO - Insights into Imaging
DO - 10.1186/s13244-026-02450-x
UR - https://link.springer.com/article/10.1186/s13244-026-02450-x
AB - Objective: To evaluate the impact of a prostate imaging quality (PI-QUAL) v2 lecture on the accuracy and inter-reader agreement of prostate MRI image-quality assessment among radiologists and technologists from diverse professional backgrounds and institutions, and to evaluate its role in institutional-level quality improvement through a quality control (QC) process. Materials and methods: Ten participants (five radiologists and five technologists) from five different hospitals independently evaluated 15 prostate MRIs before and after a standardized PI-QUAL v2 lecture. Reference scores were established by two experienced radiologists. Concordance with reference was assessed using accuracy and balanced accuracy. Inter-reader agreement was measured using percent agreement (PA) and Gwet’s AC1. Subgroup analyses were conducted based on participant characteristics. For the quality assurance and QC (QA/QC), each center submitted 15 prostate MRIs before and after the lecture. Image quality was evaluated centrally to assess institutional improvement. Results: Overall accuracy increased from 66.7% to 76.7%, and balanced accuracy increased from 62.9% to 84.2%; the mixed-effects model indicated significantly higher post-lecture accuracy ( p = 0.038). Accuracy was also higher across all subgroups. Inter-reader agreement improved from PA 57.6% to 72.6% and Gwet’s AC1 from 0.214 to 0.466. Through the QA/QC process, three centers initially failed to meet PI-QUAL v2 technical criteria. After feedback, all post-intervention scans achieved PI-QUAL v2 scores > 1. Conclusion: A structured PI-QUAL v2 lecture improved both the accuracy and inter-reader agreement of prostate MRI image-quality assessments among diverse evaluators. Incorporating QA/QC further enhanced institutional image quality. PI-QUAL v2 training is a feasible strategy for standardizing prostate MRI quality. Key Points: Question Does a structured PI-QUAL v2 lecture for radiologists and technologists improve prostate MRI quality assessment performance and institutional imaging practice across institutions? Findings PI-QUAL v2 training improved accuracy (66.7% to 76.7%) and inter-reader agreement in prostate MRI quality assessment, while QA/QC feedback enhanced institutional imaging quality. Clinical relevance statement Structured PI-QUAL v2 education combined with quality assurance and quality control feedback improves evaluator consistency and institutional prostate MRI quality, facilitating standardized image-quality assessment and broader implementation of high-quality prostate MRI in clinical radiology.
SN - 1869-4101
ER -