Bladder cancer tends to show peak enhancement with the 60-second scanning delay. Multi-detector row helical CT is useful in the detection and staging of bladder cancer.

Background: There are no standardized and well-validated criteria for assessing the risk of extraprostatic extension (EPE) of prostate cancer at preoperative multiparametric MRI.Purpose: To compare diagnostic performance, intra-and interreader agreement, and correlations of MRI-based criteria for assessment of EPE after radical prostatectomy, including EPE grade, European Society of Urogenital Radiology (ESUR) score, Likert scale, and capsular contact length (CCL). Materials and Methods:This retrospective study included consecutive men who underwent MRI and radical prostatectomy between July 2016 and March 2017. Two genitourinary radiologists independently estimated the probability of EPE by using four MRIbased scoring methods. The diagnostic accuracies and intra-and interobserver agreement were evaluated with area under the receiver operating characteristic curve (AUC) and k statistics, respectively. Correlations between MRI-based score and histologic extent of EPE were analyzed by using the Spearman correlation coefficient (r).Results: A total of 301 men (mean age 6 standard deviation, 65 years 6 7) were evaluated. A total of 129 (42.9%) men had EPE. The AUC ranges of EPE grade, ESUR score, Likert scale, and CCL for assessment of EPE were 0.77-0.81, 0.79-0.81, 0.78-0.79, and 0.78-0.85, respectively, for the two readers. The Likert scale showed lower sensitivity (68.2% [88 of 129] for reader 1, 72.1% [93 of 129] for reader 2) than did EPE grade (77.5% [100 of 129] for reader 1, 79.8% [103 of 129] for reader 2; P  .04). Intraand interreader agreement were substantial (k range, 0.61-0.74) for the four methods, with ESUR score showing the lowest values (k = 0.61 and k = 0.63, respectively). EPE grade showed highest correlation with histologic extent of EPE (r = 0.53 and r = 0.55 for circumferential length; r = 0.42 and r = 0.55 for radial length for readers 1 and 2, respectively; P , .001). Conclusion:Extraprostatic extension (EPE) grade, European Society of Urogenital Radiology score, Likert scale, and capsular contact length showed good overall diagnostic performance; however, the EPE grade resulted in more reliable performance and had the highest correlation with histologic EPE extent.

Background: The Prostate Imaging Reporting and Data System (PI-RADS) was introduced in 2012 and updated to version 2.1 (v2.1) in early 2019 to improve diagnostic performance and interreader reliability. Purpose: To evaluate the diagnostic performance of PI-RADS v2.1 in comparison with v2. Methods: A systematic review and meta-analysis of the literature was performed using MEDLINE, EMBASE, and Cochrane databases to identify studies evaluating the diagnostic performance of PI-RADS v2.1 for diagnosing clinically significant prostate cancer (csPCa). Study Type: Systematic review and meta-analysis. Subject: One thousand two hundred forty-eight patients with 1406 lesions from 10 eligible articles. Field Strength/sequence: Conventional MR sequences at 1.5 T and 3 T. Assessment: Two reviewers independently identified and reviewed the original articles reporting diagnostic performance of PI-RADS v2.1. Statistical Tests: Meta-analytic summary sensitivity and specificity were calculated using a bivariate random effects model. Meta-analytic sensitivity and specificity between PI-RADS v2 and v2.1 were compared. Results: The pooled sensitivity and specificity of PI-RADS v2.1 were 87% (95% confidence intervals, 82-91%) and 74% (63-82%), respectively. In five studies available for a head-to-head comparison between PI-RADS v2.1 and v2, there were no significant differences in either sensitivity (90% [86-94%] vs. 88% [83-93%], respectively) or specificity (76% [59-93%] vs. 61% [39-83%], respectively; P = 0.37). The sensitivity and specificity were 81% (73-87%) and 82% (68-91%), respectively, for a PI-RADS score cutoff of ≥4, and 94% (88-97%) and 56% (35-97%) for ≥3. Regarding the zonal location, the sensitivity and specificity for the transitional zone only were 90% (84-96%) and 76% (62-90%) respectively, whereas for the whole gland they were 85% (79-91%) and 71% (57-85%). Data Conclusion: PI-RADS v2.1 demonstrated good overall performance for the diagnosis of csPCa. PI-RADS v2.1 tended to show higher specificity than v2, but the difference lacked statistical significance. Level of Evidence: 3 Technical Efficacy Stage: 3