Diagnostic Performance and Interobserver Consistency of the Prostate Imaging Reporting and Data System Version 2

Zan, Ke; Wang, Liang; Min, Xiangde; Kang, Zhuang; Zhang, Peipei; Li, Ba-Sen; You, Huijuan; Hou, Shengchao

doi:10.4103/0366-6999.235872

Cited by 10 publications

(8 citation statements)

References 31 publications

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“…This may limit the applicability of our results for single readers in clinical practice. Reports indicate that inter-reader reproducibility of PI-RADS v2 tends to be moderate and experience dependent [29, 30]. We would therefore expect that expert single readers would have similar performance to that reported in the present study.…”

Section: Discussionsupporting

confidence: 78%

Low PI-RADS assessment category excludes extraprostatic extension (≥pT3a) of prostate cancer: a histology-validated study including 301 operated patients

et al. 2019

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Objectives To evaluate whether low PI-RADS v2 assessment categories are effective at excluding extraprostatic extension (EPE) of prostate cancer (≥pT3a PCa). Methods The local institutional ethics committee approved this retrospective analysis of 301 consecutive PCa patients. Patients were classified as low- or intermediate/high-risk based on clinical parameters and underwent pre-surgical multiparametric magnetic resonance imaging. A PI-RADS v2 assessment category and ESUR EPE score were assigned for each lesion by two readers working in consensus. Histopathologic analysis of the whole-mount radical prostatectomy specimen was the reference standard. Univariate and multivariate analyses were performed to evaluate the association of PI-RADS v2 assessment category with final histology ≥pT3a PCa. Results For a PI-RADS v2 assessment category threshold of 3, the overall performance for ruling out (sensitivity, negative predictive value, negative likelihood ratio) ≥pT3a PCa was 99%/98%/0.04 and was similar in both the low-risk (96%/97%/0.12; N = 137) and the intermediate/high-risk groups (100%/100%/0.0; N = 164). In univariate analysis, all clinical and tumor characteristics except age were significantly associated with ≥pT3a PCa. In multivariate analysis, PI-RADS v2 assessment categories ≤ 3 had a protective effect relative to categories 4 and 5. The inclusion of ESUR EPE score improved the AUC of ≥pT3a PCa prediction (from 0.73 to 0.86, p = 0.04 in the overall cohort). The impact of PI-RADS v2 assessment category is reflected in a nomogram derived on the basis of our cohort. Conclusions In our cohort, low PI-RADS v2 assessment categories of 3 or less confidently ruled out the presence of ≥pT3a PCa irrespective of clinical risk group. Key Points • Our analysis of 301 mp-MRI and RARP specimens showed that the addition of PI-RADS v2 assessment categories to clinical parameters improves the exclusion of ≥pT3a (extraprostatic) prostate cancer. • PI-RADS v2 assessment categories of 1 to 3 are useful for excluding ≥pT3a prostate cancer with a NPV of 98%; such patients can be considered as candidates for less invasive approaches. • The ability to exclude ≥pT3a prostate cancer may improve confidence in choosing nerve-sparing surgery or in avoiding pelvic nodal dissections, and similarly for patients undergoing radiotherapy, in adopting short-course adjuvant hormonal therapy or foregoing prophylactic nodal irradiation. Electronic supplementary material The online version of this article (10.1007/s00330-019-06092-0) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 78%

Low PI-RADS assessment category excludes extraprostatic extension (≥pT3a) of prostate cancer: a histology-validated study including 301 operated patients

et al. 2019

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“…One study reported that good interobserver agreement rates use the most appropriate analysis (AC1 = 0.71) and moderate use kappa analysis (kappa = 0.43) [17]. Few studies reported good interobserver agreement using PI-RADS V2 with a remarkable effect on the radiologist's prior experience [19][20][21][22][23][24]. In our work, we found an excellent interobserver agreement using PI-RADS-v2 in reporting MP-MRI for prostate lesions.…”

Section: Discussionsupporting

confidence: 49%

“…The main target is to build acceptable technical standards for prostate mp-MRI, which makes it clear and simpler with subsequent standardized reporting terms, as well as help the procedure of MRI-guided biopsy. It also develops assessment groups that summarize ranks of the risk that could be helpful to choose and prepare patients for the next steps in management and finally enhance interdisciplinary communications with physicians [6,[9][10][11][12][13][14][15][16][17][18][19]. Having both targeted and systematic biopsy could offer the peak discovery of clinically significant prostate cancer [20][21][22][23][24][25][26][27].…”

Section: Introductionmentioning

confidence: 99%

“…Numerous MRI-guided sampling procedures will enhance the recognition of clinically significant PCa as well as decrease the discovery of insignificant cancer decreasing the unnecessary costly treatments and their possible complications [27]. Many studies discussed the interobserver agreement of PI-RADS-v2 in the assessment and discovery of prostate cancer [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. The uniqueness of our study is the assessment of interobserver in the peripheral zone (PZ) and the central zone (CZ) separately, as well as the interobserver agreement of the different pulse sequences of PI-RADS-v2.…”

Section: Introductionmentioning

confidence: 99%

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Interobserver agreement of Prostate Imaging–Reporting and Data System (PI-RADS–v2)

Ahmed

Ebeed

Hamdy

et al. 2021

Egypt J Radiol Nucl Med

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Background A retrospective study was conducted on 71 consecutive patients with suspected prostate cancer (PCa) with a mean age of 56 years and underwent mp-MRI of the prostate at 3 Tesla MRI. Two readers recognized all prostatic lesions, and each lesion had a score according to Prostate Imaging–Reporting and Data System version 2 (PI-RADS-v2). Purpose of the study To evaluate the interobserver agreement of PI-RADS-v2 in characterization of prostatic lesions using multiparametric MRI (mp-MRI) at 3 Tesla MRI. Results The overall interobserver agreement of PI-RADS-v2 for both zones was excellent (k = 0.81, percent agreement = 94.9%). In the peripheral zone (PZ) lesions are the interobserver agreement for PI-RADS II (k = 0.78, percent agreement = 83.9%), PI-RADS III (k = 0.66, percent agreement = 91.3 %), PI-RADS IV (k = 0.69, percent agreement = 93.5%), and PI-RADS V (k = 0.91, percent agreement = 95.7 %). In the transitional zone (TZ) lesions are the interobserver agreement for PI-RADS I (k = 0.98, percent of agreement = 96%), PI-RADS II (k = 0.65, percent agreement = 96%), PI-RADS III (k = 0.65, percent agreement = 88%), PI-RADS IV (k = 0.83, percent agreement = 96%), and PI-RADS V (k = 0.82, percent agreement = 92%). Conclusion We concluded that PI-RADS-v2 is a reliable and a reproducible imaging modality for the characterization of prostatic lesions and detection of PCa.

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“…Greer et al [74] reported excellent agreement on index lesion identification (k = 0.87) and moderate agreement on individual PI-RADS v2 category assignment (k = 0.419). Other two welldesigned studies [75,76] reported similar results, with an area under the curve (AUC) for PCa ranging between 0.88 and 0.95 among six blinded readers [75]. Conversely, two recent studies showed high variability in PI-RADS v2 reporting [77,78].…”

Section: 6mentioning

confidence: 82%

Factors Influencing Variability in the Performance of Multiparametric Magnetic Resonance Imaging in Detecting Clinically Significant Prostate Cancer: A Systematic Literature Review

Stabile

Giganti

Kasivisvanathan

et al. 2020

European Urology Oncology

105

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Context: There is a lack of comprehensive data regarding the factors that influence the diagnostic accuracy of multiparametric magnetic resonance imaging (mpMRI) to detect and localize clinically significant prostate cancer (csPCa). Objective: To systematically review the current literature assessing the factors influencing the variability of mpMRI performance in csPCa diagnosis. Evidence acquisition: A computerized bibliographic search of Medline/PubMed database was performed for all studies assessing magnetic field strength, use of an endorectal coil, assessment system used by radiologists and inter-reader variability, experience of radiologists and urologists, use of a contrast agent, and use of computer-aided diagnosis (CAD) tools in relation to mpMRI diagnostic accuracy. Evidence synthesis: A total of 77 articles were included. Both radiologists' reading experience and urologists'/radiologists' biopsy experience were the main factors that influenced diagnostic accuracy. Therefore, it is mandatory to indicate the experience of the interpreting radiologists and biopsy-performing urologists to support the reliability of the findings. The most recent Prostate Imaging Reporting and Data System (PI-RADS) guidelines are recommended for use as the main

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Diagnostic Performance and Interobserver Consistency of the Prostate Imaging Reporting and Data System Version 2

Cited by 10 publications

References 31 publications

Low PI-RADS assessment category excludes extraprostatic extension (≥pT3a) of prostate cancer: a histology-validated study including 301 operated patients

Low PI-RADS assessment category excludes extraprostatic extension (≥pT3a) of prostate cancer: a histology-validated study including 301 operated patients

Interobserver agreement of Prostate Imaging–Reporting and Data System (PI-RADS–v2)

Factors Influencing Variability in the Performance of Multiparametric Magnetic Resonance Imaging in Detecting Clinically Significant Prostate Cancer: A Systematic Literature Review

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