Comparison of PI-RADS version 2 and PI-RADS version 2.1 for the detection of transition zone prostate cancer

Tamada, Tsutomu; Kido, Ayumu; Takeuchi, Mitsuru; Yamamoto, Akira; Miyaji, Yoshiyuki; Kanomata, Naoki; Sone, Toshio

doi:10.1016/j.ejrad.2019.108704

Cited by 75 publications

(68 citation statements)

References 25 publications

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“…However, since the κ values depend on many factors (including the prevalence of disease) [28], it makes no sense to compare κ value obtained in different studies. To account for this, PI-RADS v2 and 2.1 scoring should both be assigned on the same group of patients, as done in recent studies by Tamada et al and Byun et al [24,25].…”

Section: Discussionmentioning

confidence: 99%

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Assessment of DCE Utility for PCa Diagnosis Using PI-RADS v2.1: Effects on Diagnostic Accuracy and Reproducibility

et al. 2020

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The role of dynamic contrast-enhanced-MRI (DCE-MRI) for Prostate Imaging-Reporting and Data System (PI-RADS) scoring is a controversial topic. In this retrospective study, we aimed to measure the added value of DCE-MRI in combination with T2-weighted (T2W) and diffusion-weighted imaging (DWI) using PI-RADS v2.1, in terms of reproducibility and diagnostic accuracy, for detection of prostate cancer (PCa) and clinically significant PCa (CS-PCa, for Gleason Score ≥ 7). 117 lesions in 111 patients were identified as suspicion by multiparametric MRI (mpMRI) and addressed for biopsy. Three experienced readers independently assessed PI-RADS score, first using biparametric MRI (bpMRI, including DWI and T2W), and then multiparametric MRI (also including DCE). The inter-rater and inter-method agreement (bpMRI- vs. mpMRI-based scores) were assessed by Cohen’s kappa (κ). Receiver operating characteristics (ROC) analysis was performed to evaluate the diagnostic accuracy for PCa and CS-PCa detection among the two scores. Inter-rater agreement was excellent for the three pairs of readers (κ ≥ 0.83), while the inter-method agreement was good (κ ≥ 0.73). Areas under the ROC curve (AUC) showed similar high-values (0.8 ≤ AUC ≤ 0.85). The reproducibility of PI-RADS v2.1 scoring was comparable and high among readers, without relevant differences, depending on the MRI protocol used. The inclusion of DCE did not influence the diagnostic accuracy.

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Section: Discussionmentioning

confidence: 99%

“…Because of the recent introduction of PI-RADS v2.1, studies evaluating its accuracy are few [24,25], and none of these aims to investigate the actual value of DCE for the PI-RADS assignment of PCa lesions.…”

Section: Introductionmentioning

confidence: 99%

Assessment of DCE Utility for PCa Diagnosis Using PI-RADS v2.1: Effects on Diagnostic Accuracy and Reproducibility

et al. 2020

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“…Since then, several studies have assessed its diagnostic accuracy; One meta-analysis, consisting of 13 studies, revealed a pooled sensitivity of 85% and specificity of 71% for PCa detection [8]; A second meta-analysis included 21 studies and reported pooled sensitivities and specificities of 89% and 73%, respectively [7]. PI-RADS v2.1, however, is expected to improve diagnostic accuracy especially for lesions of the transition zone [17]. In our cohort, a sensitivity of 82.1% and specificity of 85.4% was achieved.…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, even studies among experts describe only moderate agreement (kappa = 0.55) [9], which might be due to the subjective image impressions used for the PI-RADS classifications. PI-RADS v2.1 was developed, among other objectives, with the anticipation of an increased interreader agreement, which has recently been shown for lesions of the transition zone [17,19]. Nevertheless, PI-RADS v2.1-based evaluation is still subject to perceived image impressions, which makes it possibly susceptible to interobserver variability.…”

Section: Discussionmentioning

confidence: 99%

Computer-Aided Diagnosis in Multiparametric MRI of the Prostate: An Open-Access Online Tool for Lesion Classification with High Accuracy

Ellmann

Schlicht

Dietzel

et al. 2020

Cancers

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Computer-aided diagnosis (CADx) approaches could help to objectify reporting on prostate mpMRI, but their use in many cases is hampered due to common-built algorithms that are not publicly available. The aim of this study was to develop an open-access CADx algorithm with high accuracy for classification of suspicious lesions in mpMRI of the prostate. This retrospective study was approved by the local ethics commission, with waiver of informed consent. A total of 124 patients with 195 reported lesions were included. All patients received mpMRI of the prostate between 2014 and 2017, and transrectal ultrasound (TRUS)-guided and targeted biopsy within a time period of 30 days. Histopathology of the biopsy cores served as a standard of reference. Acquired imaging parameters included the size of the lesion, signal intensity (T2w images), diffusion restriction, prostate volume, and several dynamic parameters along with the clinical parameters patient age and serum PSA level. Inter-reader agreement of the imaging parameters was assessed by calculating intraclass correlation coefficients. The dataset was stratified into a train set and test set (156 and 39 lesions in 100 and 24 patients, respectively). Using the above parameters, a CADx based on an Extreme Gradient Boosting algorithm was developed on the train set, and tested on the test set. Performance optimization was focused on maximizing the area under the Receiver Operating Characteristic curve (ROCAUC). The algorithm was made publicly available on the internet. The CADx reached an ROCAUC of 0.908 during training, and 0.913 during testing (p = 0.93). Additionally, established rule-in and rule-out criteria allowed classifying 35.8% of the malignant and 49.4% of the benign lesions with error rates of <2%. All imaging parameters featured excellent inter-reader agreement. This study presents an open-access CADx for classification of suspicious lesions in mpMRI of the prostate with high accuracy. Applying the provided rule-in and rule-out criteria might facilitate to further stratify the management of patients at risk.

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“…Thus, DCE-MRI is currently utilized as a qualitative technique merely assisting the clinical interpretation of diffusion weighted imaging (DWI) or T2 weighted (T2W) MRI in a standardof-care multi-parametric MRI (mpMRI) of the prostate based on Prostate Imaging Reporting and Data System version 2.1 (9). This yields reasonable diagnostic accuracy, but it has fundamental limitation due to its nature of subjective assessment, leading to inter-observer variation (10).…”

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confidence: 99%

Portable Perfusion Phantom Offers Quantitative Dynamic Contrast-Enhanced Magnetic Resonance Imaging for Accurate Prostate Cancer Grade Stratification: A Pilot Study

et al. 2021

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Rationale and Objectives: The study goal was to test whether the improved accuracy in quantitative dynamic contrast-enhanced magnetic resonance imaging measurement using a point-of-care portable perfusion phantom (P4) leads to better stratification of prostate cancer grade. Materials and Methods: A prospective clinical study was conducted recruiting 44 patients scheduled for multi-parameter MRI prostate exams. All participants were imaged with the P4 placed under their pelvic regions. Tissue sampling was carried out for 25 patients at 22 § 18 (mean § SD) days after multi-parameter MRI. On histologic examination, a total of 31 lesions were confirmed as prostate cancer. Tumors were classified into low grade (n = 14), intermediate grade (n = 10), and high grade (n = 7). Tumor perfusion was assessed by volume transfer constant, K trans , before and after P4-based error correction, and the K trans of low, intermediate and high-grade tumors were statistically compared. Results: After P4-based error correction, the K trans of low, intermediate, and high-grade tumors were 0.109 § 0.026 min À1 (95% CI: 0.0094 to 0.124 min À1), 0.163 § 0.049 min À1 (95% CI: 0.129 to 0.198 min À1) and 0.356 § 0.156 min À1 (95% CI: 0.215 to 0.495 min À1), respectively, with statistically significant difference among the groups (low vs intermediate: p = 0.002; intermediate vs high: p = 0.002; low vs high: p < 0.001). The sensitivity and specificity of K trans value, 0.14 min À1 , to detect the clinically significant prostate cancer were 88% and 93%, respectively, after P4 based error correction, but those before error correction were 88% and 86%, respectively. Conclusion: The P4 allows to reduce errors in quantitative dynamic contrast-enhanced magnetic resonance imaging measurement, enhancing accuracy in stratification of prostate cancer grade.

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Comparison of PI-RADS version 2 and PI-RADS version 2.1 for the detection of transition zone prostate cancer

Cited by 75 publications

References 25 publications

Assessment of DCE Utility for PCa Diagnosis Using PI-RADS v2.1: Effects on Diagnostic Accuracy and Reproducibility

Assessment of DCE Utility for PCa Diagnosis Using PI-RADS v2.1: Effects on Diagnostic Accuracy and Reproducibility

Computer-Aided Diagnosis in Multiparametric MRI of the Prostate: An Open-Access Online Tool for Lesion Classification with High Accuracy

Portable Perfusion Phantom Offers Quantitative Dynamic Contrast-Enhanced Magnetic Resonance Imaging for Accurate Prostate Cancer Grade Stratification: A Pilot Study

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