Improving Prostate MRI: Lessons Learned from the American College of Radiology’s Prostate MR Image Quality Improvement Collaborative

MRI is an essential tool in diagnosis and management of prostate cancer. However, image quality and interpretation variability continue to hinder its broader adoption in clinical practice. To address the challenge of inconsistent image quality, the American College of Radiology (ACR) launched the Prostate MR Image Quality Improvement Collaborative, an initiative within the ACR Learning Network. To date, three cohorts comprising 14 organizations have participated in the program, which was built on the ACR ImPower continuous improvement framework. The organizations identified four main key drivers for prostate MR image quality: protocol optimization, patient preparation, personnel training, and performance monitoring and feedback. Examples of interventions designed to address these areas included incorporating protocol adjustments to comply with the Prostate Imaging Reporting and Data System version 2.1, changing the phase-encoding direction of diffusion-weighted and T2-weighted images, including artifact-resistant and artificial intelligence-enhanced sequences in the MRI protocol, developing and implementing patient preparation instructions regarding use of saline enema and dietary restrictions, training technologists on the importance of image quality and how to troubleshoot imaging artifacts, and performing systematic audits of the MRI examinations using the Prostate Imaging Quality System. The Collaborative also fostered a culture of continuous improvement and teamwork, which led to operational efficiencies and improved job satisfaction among frontline staff. The authors outline the Collaborative's framework and lessons learned, offering a practical road map for institutions aiming to achieve and sustain high-quality prostate MRI. ^©RSNA, 2025 Supplemental material is available for this article.