“Very special to be the first non-urologist to win this award”

This determination has brought Prof. Barentsz, professor of radiology and chair of the Prostate MRI Reference Center at the Radboudumc in Nijmegen (NL), the EAU Innovators in Urology Award. This award was originally scheduled to be bestowed at EAU20 in Amsterdam and was eventually given to Prof. Barentsz in the build-up to EAU21 Virtual. The award is presented “in recognition of the importance of inventions and clinical contributions with a major impact on the treatment and/or diagnosis of a urological disease.” Prof. Barentsz won this award because of his achievements in functional and molecular imaging in the field of prostate cancer MRI. He and his team were responsible for the introduction of the Prostate Imaging – Reporting and Data System (PI-RADS), which has found its way in clinical guidelines across the world, including the EAU Guidelines.

“MRI imaging has a hugely positive effect on the treatment of the patient. It decreases side effects and increases the chances of cure,” Prof. Barentsz says. “I have been awarded many prizes, among which the royal decoration of Knight in the Order of the Lion of the Netherlands, which is like knighthood in the UK. But the EAU Innovators in Urology Award is an even more important prize to me than that. Why? Because before me, this prize was granted to what I call the ‘urological icons’, such as John Wickham, who was a pioneer of extracorporeal shock-wave lithotripsy and laparoscopic nephrectomy. Being a radiologist, I am the first non-urologist who is granted this award. It is very special to get this kind of distinction from clinicians. This is a huge appreciation for and promotion of imaging. And that was my motivation to start in radiology: to promote imaging.”

Not your or my but our patient
That motivation stemmed from Prof. Barentsz’ experiences with colleagues who “didn’t recognise the important impact imaging had on the treatment options for the patient.” “Many clinicians, especially twenty to thirty years ago, did not appreciate radiology,” he remembers. “Urologists were opposed to the idea of using MRI to detect clinically significant prostate cancer. Some of them still are. To them I would like to say: why are you against this? I personally only care about what I can do for the patient. This patient is not yours or mine; this is our patient. Consider what we can do for them if we collaborate with a mind open to new ideas. I am having a lot of discussions with prostate cancer patient societies, and they really want MRI. Imaging is one piece of the puzzle in a patient’s journey, a piece that is just as important as the treatment. Imaging can help clinicians find a way in the dark; it is a road map. That is my ultimate goal for imaging; that it is recognised as this important piece of the puzzle by all clinicians. Receiving this prize from the world-leading association in urology is a huge step toward achieving this.”

Quality assurance
Another huge step would be a quality assurance for prostate MRI throughout Europe. Prof. Barentsz: “In many hospitals the MRI isn’t good enough. In my country the Netherlands, we don’t have enough MRI scanners to support the guidelines. We are working on that in the Radiological Society of the Netherlands [NVvR, Ed.]. The hurdles are financial and quality ones. The financial issue can be solved with the help of hospital directors, healthcare providers, insurance companies, and politicians. There needs to be a shift of money to MRI. As for the quality issue, we need to educate more radiologists using accreditation and certification. We are working on all of this, and the blueprints are there. For instance, the NVvR will soon discuss how to implement good-quality MRI with the Dutch Association of Urology and the Dutch Association for Prostate Cancer Patients.”

Many more developments are afoot – such as early detection of prostate cancer and the use of artificial intelligence in this – but Prof. Barentsz cannot help but notice he is “gradually moving toward the age where people say you have to retire.” But: “Fortunately, all those developments are not beyond but in front of the horizon. And I may be able to shift the horizon a bit further away from me.”