FOCAL THERAPY OF PROSTATE AND KIDNEY CANCER: Edited by Jean de la Rosette and Thomas J. PolascikThree-dimensional localization and targeting of prostate cancer foci with imaging and histopathologic correlation establishing a multidisciplinary team for quality improvementAminsharifi, Alirezaa,b; Gupta, Rajan T.c; Huang, Jiaotid; Polascik, Thomas J.a Author Information aDivision of Urological Surgery, Duke University Medical Center, Duke Cancer Institute, Durham, NC bDepartment of Urology, Shiraz University of Medical Sciences, Shiraz, Iran cDepartments of Radiology and Surgery, Duke University Medical Center, Duke Cancer Institute dDepartment of Pathology, Duke University Medical Center, Durham, NC, USA Correspondence to Thomas J. Polascik, MD, FACS, Duke Cancer Institute, Room 1080 Yellow Zone, Duke South, Durham, NC 27710, USA. E-mail: [email protected] Current Opinion in Urology: November 2018 - Volume 28 - Issue 6 - p 506-511 doi: 10.1097/MOU.0000000000000554 Buy Metrics Abstract Purpose of review The current trend in image-based identification and characterization of prostate cancer (PCa) utilizing multiparametric MRI (mpMRI) has affected diagnostic and treatment planning in terms of targeted biopsy, risk stratification and prognostic evaluation, clinical management and follow-up. However, the accuracy of MRI to detect clinically significant disease is variable between different institutions. The role of quality control initiatives to increase the concordance between clinical-imaging–histopathological data and to improve accurate targeting of the suspicious lesions cannot be overemphasized. This article describes the approaches to correlate mpMRI findings with histopathology and the role of multidisciplinary teams for quality improvement and feedback interventions. Recent findings Validating the mpMRI and image-targeted fusion biopsy findings with prostatectomy specimen histopathology as the gold standard is essential for assessment of the concordance between clinical-imaging–histopathological data. Utilization of a MRI-derived patient-specific prostate mold enables a direct comparison between histopathological versus imaging characteristics of cancer foci in the same sectional plane of the specimen versus MRI. Furthermore, ‘reverse fusion’ technology provides the ability to audit the quality of targeting following fusion biopsy. Summary The development of a multidisciplinary team approach with group discussions, workflows to integrate and correlate clinical, imaging and histological data, as well as feedback and audit interventions can improve the quality of care when an image-based PCa diagnostic program is implemented. This needs to be executed at the local level to better understand each institutions’ performance characteristics of mpMRI and image-targeted intervention. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.