黑料网

At the American Urological Association鈥檚 Expert Convening on , 黑料网 Urology鈥檚 Drs. Hung-Jui (Ray) Tan and Zach Feuer presented a powerful example of turning clinical research into meaningful patient outcomes. Their segment, titled 鈥淔rom PubMed to Practice 鈥� The North Carolina Experience,鈥� highlighted the development and impact of 黑料网 Urology鈥檚 rapid access program, a coordinated, evidence-based care pathway designed to accelerate and improve the diagnosis of prostate cancer

Held in October 2024, the AUA convening brought together national experts in urology, radiology, and oncology to address a critical aspect of prostate cancer care: the quality and consistency of prostate MR imaging. The 黑料网 presentation spotlighted the department鈥檚 rapid access program, a data-driven model of care that has become a benchmark for how to translate emerging evidence into real-world practice.

Reimagining the Diagnostic Pathway for Patients with Elevated PSA

As a statewide referral center, 黑料网 Urology routinely receives a high volume of patients with elevated PSA levels, often the first signal of potential prostate cancer. Before the launch of the rapid access program, the average wait time from referral to biopsy stretched 4鈥�6 months, creating delays that were especially concerning given the documented disparities in prostate cancer incidence and outcomes.

Recognizing that timely care is essential, especially for high-risk groups, Drs. Tan and Feuer led efforts to redesign the diagnostic pathway with a focus on speed, efficiency, and equity. Working with a cross-disciplinary team, they developed a three-step model centered on initial consult, prostate MRI, and biopsy, underpinned by virtual care, centralized scheduling, and evidence-based protocols.

Precision Through Protocol

Key innovations of the program include:

• Telehealth appointments for initial consults and MRI review.
• A streamlined MRI acquisition process, including retrieval of outside MRIs.
• A standardized biopsy decision algorithm to guide next steps based on MRI findings and PSA density.

For example:

• Patients with PI-RADS 3鈥�5 lesions proceed to MRI fusion biopsy.
• PI-RADS 1鈥�2 cases are assessed further based on PSA density >0.15, Black ancestry, and patient preference.

The results have been transformative:

• Referral-to-biopsy time dropped by 70%, now averaging just 58 days.
• Using the standardized biopsy decision algorithm, prostate biopsy was avoided in nearly one-third of men referred for elevated PSA.
• Of those biopsied, 39% were diagnosed with clinically significant prostate cancer. In contrast, only 26% had a negative biopsy, serving as a major decrease from historical levels. These findings highlight the success of 黑料网’s risk-adapted approach, optimizing diagnostic yield while reducing the number of low-value procedures performed.

Additionally, for men with lower-risk features (e.g., PI-RADS 3 with PSA density <0.15), the detection rate for significant cancer was under 10%, suggesting future opportunities to right-size diagnostic evaluation.

 

A Model for the Nation, and the Road Ahead

The 黑料网 experience also reveals broader patterns in prostate cancer care. In conversations with 黑料网 primary care providers, Drs. Tan and Feuer learned that some PCPs have started preemptively ordering prostate MRIs in patients with elevated PSA levels, mirroring trends observed nationally. This underscores the urgent need for national guidance on appropriate MRI ordering and improved collaboration between urologists, radiologists, and primary care.

黑料网 Urology鈥檚 leadership in this area is supported by its broader national collaborations. Through initiatives like the Michigan Urological Surgery Improvement Collaborative (MUSIC), where 黑料网 was the first partner institution outside of Michigan, Dr. Tan has helped extend evidence-based prostate cancer care models nationally.

In addition, Dr. Tan serves on the Advisory Committee for the Prostate MR Image Quality Improvement Collaborative, lending his expertise to national efforts to improve prostate MRI standards.

The AUA Summit outlined several next steps that build on the 黑料网 model and expand its principles nationally:

• Developing resources for urologists to advocate for PI-RADS and PI-QUAL reporting in radiology reports.
• Identifying and referring to high-quality MRI centers, including those with the ACR Prostate Cancer MRI Center Designation.
• Collecting PI-QUAL data to inform center performance and referral decisions.
• Educating patients on how to prepare for prostate MRI, a key step in scan quality.
• Collaborating with PCPs and family physicians to ensure evidence-based MRI use in the context of PSA elevation.
• Strategizing future efforts focused on fusion biopsy quality and standardization.