For prostate cancer detection on prostate multiparametric MRI (mpMRI), the Prostate Imaging-Reporting and Data System version 2 (PI-RADSv2) and computer-aided diagnosis (CAD) systems aim to widely improve standardization across radiologists and centers. Our goal was to evaluate CAD assistance in prostate cancer detection compared with conventional mpMRI interpretation in a diverse dataset acquired from five institutions tested by nine readers of varying experience levels, in total representing 14 globally spread institutions.Index lesion sensitivities of mpMRI-alone were 79% (whole prostate (WP)), 84% (peripheral zone (PZ)), 71% (transition zone (TZ)), similar to CAD at 76% (WP, p=0.39), 77% (PZ, p=0.07), 79% (TZ, p=0.15). Greatest CAD benefit was in TZ for moderately-experienced readers at PI-RADSv2 <3 (84% vs mpMRI-alone 67%, p=0.055). Detection agreement was unchanged but CAD-assisted read times improved (4.6 vs 3.4 minutes, p<0.001). At PI-RADSv2 ≥ 3, CAD improved patient-level specificity (72%) compared to mpMRI-alone (45%, p<0.001).PI-RADSv2 and CAD-assisted mpMRI interpretations have similar sensitivities across multiple sites and readers while CAD has potential to improve specificity and moderately-experienced radiologists’ detection of more difficult tumors in the center of the gland. The multi-institutional evidence provided is essential to future prostate MRI and CAD development.

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Of 215 TIPS placed for purposes other than hemorrhage, the TIPS was inserted at the bifurcation in 41 patients and intrahepatic in 62 patients. Red blood cell transfusions were administered in 10% of patients in each group within 3 days post procedure (p ¼ 1.0). Pharmacologic vasopressor support was utilized in 7% of the bifurcation TIPS and 5% of the intrahepatic TIPS (p ¼ 0.68). There were no significant differences in 30-day mortality rates (2% for bifurcation TIPS compared to 3% for intrahepatic TIPS, p ¼ 1.0). Similarly, no significant difference comparing left to right-sided TIPS. No deaths were directly related to hemorrhagic complications. Neither thrombocytopenia nor a high INR correlated significantly with hemorrhage risk. Conclusions: The risk of hemorrhagic complications was similar in both groups, without any hemorrhage-related deaths. Therefore, TIPS insertion at or near the portal bifurcation may be considered a reasonable access in the setting of Viatorr stent graft use.