Direct comparison of PI-RADS version 2 and version 1 regarding interreader agreement and diagnostic accuracy for the detection of clinically significant prostate cancer

Becker, Anton S.; Cornelius, Alexander; Reiner, Cäcilia S.; Stocker, Daniel; Ulbrich, Erika J.; Barth, Borna K.; Mortezavi, Ashkan; Eberli, Daniel; Donati, Olivio F.

doi:10.1016/j.ejrad.2017.07.016

Cited by 37 publications

(14 citation statements)

References 26 publications

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“…In 2012 the first version of PI-RADS was published 1 , and in late 2014 PI-RADS v2.0 was released 2 . PI-RADS has been rapidly accepted among the radiological and urological community and is being incorporated into clinical care pathways 3 , as many studies have shown good diagnostic accuracy of the reporting system 4 – 8 .…”

Section: Introductionmentioning

confidence: 99%

Diagnostic performance of PI-RADS version 2.1 compared to version 2.0 for detection of peripheral and transition zone prostate cancer

Rudolph

Baur

Cash

et al. 2020

Sci Rep

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The purpose of this study is to compare diagnostic performance of Prostate Imaging Reporting and Data System (PI-RADS) version (v) 2.1 and 2.0 for detection of Gleason Score (GS) ≥ 7 prostate cancer on MRI. Three experienced radiologists provided PI-RADS v2.0 scores and at least 12 months later v2.1 scores on lesions in 333 prostate MRI examinations acquired between 2012 and 2015. Diagnostic performance was assessed retrospectively by using MRI/transrectal ultrasound fusion biopsy and 10-core systematic biopsy as the reference. From a total of 359 lesions, GS ≥ 7 tumor was present in 135 lesions (37.60%). Area under the ROC curve (AUC) revealed slightly lower values for peripheral zone (PZ) and transition zone (TZ) scoring in v2.1, but these differences did not reach statistical significance. A significant number of score 2 lesions in the TZ were downgraded to score 1 in v2.1 showing 0% GS ≥ 7 tumor (0/11). The newly introduced diffusion-weighted imaging (DWI) upgrading rule in v2.1 was applied in 6 lesions from a total of 143 TZ lesions (4.2%). In summary, PI-RADS v2.1 showed no statistically significant differences in overall diagnostic performance of TZ and PZ scoring compared to v2.0. Downgraded BPH nodules showed favorable cancer frequencies. The new DWI upgrading rule for TZ lesions was applied in only few cases.

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Section: Introductionmentioning

confidence: 99%

Diagnostic performance of PI-RADS version 2.1 compared to version 2.0 for detection of peripheral and transition zone prostate cancer

Rudolph

Baur

Cash

et al. 2020

Sci Rep

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“…PIRADSv1 was a powerful albeit complex scoring system, leading to an interrater agreement rate of 0.39–0.64 [47–49]. Simplification of the scoring system in PIRADSv2 significantly improved the interrater agreement: from 0.64 to 0.70 in the study of Becker et al [47], from 0.39 to 0.56 in the study of Tewes et al [48] and from 1.33 (Bland-Altman statistics for sum-score) to 0.41 in Krishna et al [49]. Interobserver agreement studies for mp- vs. bi-parametric MRI were not performed yet, a further simplification is nevertheless quite likely to improve the interrater agreement.…”

Section: Discussionmentioning

confidence: 99%

The role of gadolinium in magnetic resonance imaging for early prostate cancer diagnosis: A diagnostic accuracy study

et al. 2019

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ObjectiveProstate lesions detected with multiparametric magnetic resonance imaging (mpMRI) are classified for their malignant potential according to the Prostate Imaging-Reporting And Data System (PI-RADS™2). In this study, we evaluate the diagnostic accuracy of the mpMRI with and without gadolinium, with emphasis on the added diagnostic value of the dynamic contrast enhancement (DCE).Materials and methodsThe study was retrospective for 286 prostate lesions / 213 eligible patients, n = 116/170, and 49/59% malignant for the peripheral (Pz) and transitional zone (Tz), respectively. A stereotactic MRI-guided prostate biopsy served as the histological ground truth. All patients received a mpMRI with DCE. The influence of DCE in the prediction of malignancy was analyzed by blinded assessment of the imaging protocol without DCE and the DCE separately.ResultsSignificant (CSPca) and insignificant (IPca) prostate cancers were evaluated separately to enhance the potential effects of the DCE in the detection of CSPca. The Receiver Operating Characteristics Area Under Curve (ROC-AUC), sensitivity (Se) and specificity (Spe) of PIRADS-without-DCE in the Pz was 0.70/0.47/0.86 for all cancers (IPca and CSPca merged) and 0.73/0.54/0.82 for CSPca. PIRADS-with-DCE for the same patients showed ROC-AUC/Se/Spe of 0.70/0.49/0.86 for all Pz cancers and 0.69/0.54/0.81 for CSPca in the Pz, respectively, p>0.05 chi-squared test. Similar results for the Tz, AUC/Se/Spe for PIRADS-without-DCE was 0.75/0.61/0.79 all cancers and 0.67/0.54/0.71 for CSPca, not influenced by DCE (0.66/0.47/0.81 for all Tz cancers and 0.61/0.39/0.75 for CSPca in Tz). The added Se and Spe of DCE for the detection of CSPca was 88/34% and 78/33% in the Pz and Tz, respectively.ConclusionDCE showed no significant added diagnostic value and lower specificity for the prediction of CSPca compared to the non-enhanced sequences. Our results support that gadolinium might be omitted without mitigating the diagnostic accuracy of the mpMRI for prostate cancer.

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“…This was subsequently revised in 2015 with the development of PIRADS v2 in order to decrease variability between interpretations. Studies have since shown similar diagnostic accuracy between the two versions of PIRADS with improved inter-reader agreeability for PIRADS v2 [13,14,15,16,17]. There is a substantial body of evidence that mpMRI positively correlates with the presence of underlying disease.…”

Section: Role Of Multiparametric Mri In Prostate Cancer Diagnosis mentioning

confidence: 99%

Imaging as a Personalized Biomarker for Prostate Cancer Risk Stratification

et al. 2018

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Biomarkers provide objective data to guide clinicians in disease management. Prostate-specific antigen serves as a biomarker for screening of prostate cancer but has come under scrutiny for detection of clinically indolent disease. Multiple imaging techniques demonstrate promising results for diagnosing, staging, and determining definitive management of prostate cancer. One such modality, multiparametric magnetic resonance imaging (mpMRI), detects more clinically significant disease while missing lower volume and clinically insignificant disease. It also provides valuable information regarding tumor characteristics such as location and extraprostatic extension to guide surgical planning. Information from mpMRI may also help patients avoid unnecessary biopsies in the future. It can also be incorporated into targeted biopsies as well as following patients on active surveillance. Other novel techniques have also been developed to detect metastatic disease with advantages over traditional computer tomography and magnetic resonance imaging, which primarily rely on defined size criteria. These new techniques take advantage of underlying biological changes in prostate cancer tissue to identify metastatic disease. The purpose of this review is to present literature on imaging as a personalized biomarker for prostate cancer risk stratification.

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Direct comparison of PI-RADS version 2 and version 1 regarding interreader agreement and diagnostic accuracy for the detection of clinically significant prostate cancer

Cited by 37 publications

References 26 publications

Diagnostic performance of PI-RADS version 2.1 compared to version 2.0 for detection of peripheral and transition zone prostate cancer

Diagnostic performance of PI-RADS version 2.1 compared to version 2.0 for detection of peripheral and transition zone prostate cancer

The role of gadolinium in magnetic resonance imaging for early prostate cancer diagnosis: A diagnostic accuracy study

Imaging as a Personalized Biomarker for Prostate Cancer Risk Stratification

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