UNC Urology’s Dr. Matthew Nielsen joined Dr. Andrei Purysko of the Cleveland Clinic on a recent episode of the American Urological Association’s Inside Tract podcast to discuss the role of high-quality prostate MR imaging in advancing prostate cancer diagnosis.
The episode, titled “Advancing Prostate Cancer Diagnosis with High-Quality Prostate MR Images,” brings together two national leaders in urologic and radiologic quality improvement.
Dr. Nielsen, Chair of the Department of Urology and member of the Lineberger Comprehensive Cancer Center at the University of North Carolina at Chapel Hill and Chair of the AUA’s Science and Quality Council, has been a strong advocate for elevating diagnostic standards in prostate cancer. His conversation with Dr. Purysko, Section Head of Abdominal Imaging at Cleveland Clinic and Physician Leader of the ACR Prostate MR Image Quality Improvement Collaborative, explores how enhanced imaging standards are transforming care pathways across the country.
A Convergence of Disciplines to Improve Patient Care
The episode centers on the growing use of prostate MRI as a frontline tool for risk stratification and biopsy guidance, with a focus on how image quality directly impacts diagnostic accuracy, care decisions, and outcomes. Drs. Nielsen and Purysko reflect on the remarkable progress made since the early adoption of MRI in prostate cancer care, while also underscoring ongoing challenges with variability in image acquisition and interpretation.
Dr. Nielsen notes that collaboration across disciplines, including urology, radiology, primary care, and quality experts, is essential to address variation and drive consistency in diagnostic practice.
“We are really excited about opportunities in this space. MRI has helped us reframe how we think about the early detection of prostate cancer. But with new technologies come new responsibilities to ensure quality across the board.”
The two discuss technical standards such as PI-RADS (Prostate Imaging Reporting and Data System) and PI-QUAL (Prostate Imaging Quality), both of which serve as critical frameworks for improving how MRI is performed, interpreted, and used in clinical decision-making.
Quality Improvement with Tangible Benefits
The conversation also highlights the real-world gains being seen through quality improvement collaboratives, such as the American College of Radiology’s Learning Network, where participating centers have seen significant improvements in image quality and operational efficiency. Dr. Nielsen points out that better imaging doesn’t just improve diagnostic accuracy, it can also reduce scan time, increase patient throughput, and improve access.
“This is a win for patients, for radiology teams, and for health systems. High-quality imaging means better decisions, fewer unnecessary biopsies, and more timely access to the care that matters most.”
As Chair of the AUA’s Science and Quality Council, Dr. Nielsen has been instrumental in shaping the Association’s national quality agenda, including initiatives aimed at improving diagnostic pathways in urology.