Evaluation of the PI-RADS scoring system for mpMRI of the prostate: a whole-mount step-section analysis

Junker, Daniel; Quentin, Michael; Nagele, Udo; Edlinger, Michael; Richenberg, Jonathan; Schaefer, Georg; Ladurner, Michael; Jaschke, Werner; Horninger, Wolfgang; Aigner, Friedrich

doi:10.1007/s00345-014-1370-x

Cited by 64 publications

(55 citation statements)

References 22 publications

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“…Although the numbers are small in each subcategory and therefore a powerful statistical calculation is not possible, as the overall PI-RADS score increased the probability of diagnosing prostate cancer and discovering a clinically significant cancer got higher in our series. Junker et al (19) evaluated PI-RADS for classifying mp-MRI findings using wholemount step-section slides as the reference standard. When all single modality scores were combined, a substantially high discriminative ability of prostate cancer detection (AUC, 0.97; 95% CI, 0.95-0.99) was achieved.…”

Section: Discussionmentioning

confidence: 99%

Multiparametric MRI guidance in first-time prostate biopsies: what is the real benefit?

Acar

Esen²,

Çolakoğlu³

et al. 2015

Diagn Interv Radiol

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Section: Discussionmentioning

confidence: 99%

Multiparametric MRI guidance in first-time prostate biopsies: what is the real benefit?

Acar

Esen²,

Çolakoğlu³

et al. 2015

Diagn Interv Radiol

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“…It has resulted in high cancer detection rates of >60% in correlation with the findings on mpMRI and has good prediction of tumour aggressiveness [5,7,8].…”

Section: Introductionmentioning

confidence: 99%

Direct comparison of multiparametric magnetic resonance imaging (MRI) results with final histopathology in patients with proven prostate cancer in MRI/ultrasonography‐fusion biopsy

et al. 2016

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ObjectiveTo compare multiparametric magnetic resonance imaging (mpMRI) of the prostate and histological findings of both targeted MRI/ultrasonography-fusion prostate biopsy (PBx) and systematic PBx with final histology of the radical prostatectomy (RP) specimen. Patients and MethodsA total of 105 patients with prostate cancer (PCa) histopathologically proven using a combination of fusion Pbx and systematic PBx, who underwent RP, were investigated. All patients had been examined using mpMRI, applying the European Society of Urogenital Radiology criteria. Histological findings from the RP specimen were compared with those from the PBx. Whole-mount RP specimen and mpMRI results were directly compared by a uro-pathologist and a uro-radiologist in step-section analysis. ResultsIn the 105 patients with histopathologically proven PCa by combination of fusion PBx and systematic PBx, the detection rate of PCa was 90% (94/105) in fusion PBx alone and 68% (72/105) in systematic PBx alone (P = 0.001). The combination PBx detected 23 (22%) Gleason score (GS) 6, 69 (66%) GS 7 and 13 (12%) GS ≥8 tumours. Fusion PBx alone detected 25 (26%) GS 6, 57 (61%) GS 7 and 12 (13%) GS ≥8 tumours. Systematic PBx alone detected 17 (24%) GS 6, 49 (68%) GS 7 and 6 (8%) GS ≥8 tumours. . The rates of concordance with regard to GS between the PBx and RP specimen were 63% (n = 65), 54% (n = 56) and 75% (n = 78) in fusion, systematic and combination PBx (fusion and systematic PBx combined), respectively. Upgrading of the GS between PBx and RP specimen occurred in 33% (n = 34), 44% (n = 46) and 18% (n = 19) in fusion, systematic and combination PBx, respectively. c-correlation for detection of any cancer was 0.76 for combination PBx, 0.68 for fusion PBx alone and 0.23 for systematic PBx alone. In all, 84% (n = 88) of index tumours were identified by mpMRI; 86% (n = 91) of index lesions on the mpMRI were proven in the RP specimen. ConclusionsFusion PBx of tumour-suspicious lesions on mpMRI was associated with a higher detection rate of more aggressive PCa and a better tumour prediction in final histopathology than systematic PBx alone; however, combination PBx had the best concordance for the prediction of GS. Furthermore, the additional findings of systematic PBx reflect the multifocality of PCa, therefore, the combination of both biopsy methods would still represent the best approach for the prediction of the final tumour grading in PCa. KeywordsMRI/ultrasound-fusion biopsy, prostate cancer, multiparametric MRI, prostatectomy specimen, systematic biopsy, direct comparison

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“…Furthermore, it shows a good inter-reader agreement [9] . Especially lesions classified as PI-RADS 4 and 5 harbor a high portion of high-grade PCa [7] .…”

mentioning

confidence: 99%

“…Several studies revealed that PI-RADS appears to have a reliable diagnostic accuracy and correlation with tumor aggressiveness [6][7][8] . Furthermore, it shows a good inter-reader agreement [9] .…”

mentioning

confidence: 99%

Evaluation of Prostate Imaging Reporting and Data System Classification in the Prediction of Tumor Aggressiveness in Targeted Magnetic Resonance Imaging/Ultrasound-Fusion Biopsy

Borkowetz

Platzek²,

Toma³

et al. 2017

Urol Int

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Objectives: The study aimed to evaluate the prediction of Prostate Imaging Reporting and Data System (PI-RADS) with respect to the prostate cancer (PCa) detection rate and tumor aggressiveness in magnetic resonance imaging (MRI)/ultrasound-fusion-biopsy (fusPbx) and in systematic biopsy (sysPbx). Materials and Methods: Six hundred and twenty five patients undergoing multiparametric MRI were investigated. MRI findings were classified using PI-RADS v1 or v2. All patients underwent fusPbx combined with sysPbx (comPbx). The lesion with the highest PI-RADS was defined as maximum PI-RADS (maxPI-RADS). Gleason Score ≥7 (3 + 4) was defined as significant PCa. Results: The overall PCa detection rate was 51% (n = 321; 39% significant PCa). The detection rate was 43% in fusPbx (n = 267; 34% significant PCa) and 36% in sysPbx (n = 223; 27% significant PCa). Nine percentage of significant PCa were detected by sysPbx alone. A total of 1,162 lesions were investigated. The detection rate of significant PCa in lesions with PI-RADS 2, 3, 4, and 5 were 9% (18/206), 12% (56/450), 27% (98/358), and 61% (90/148) respectively. maxPI-RADS ≥4 was the strongest predictor for the detection of significant PCa in comPbx (OR 2.77; 95% CI 1.81-4.24; p < 0.005). Conclusions: maxPI-RADS is the strongest predictor for the detection of significant PCa in comPbx. Due to a high detection rate of additional significant PCa in sysPbx, fusPbx should still be combined with sysPbx.

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Evaluation of the PI-RADS scoring system for mpMRI of the prostate: a whole-mount step-section analysis

Abstract: The PI-RADS scoring system showed good diagnostic accuracy: Only PI-RADS 4 and 5 showed high-grade PCa. However, it seems necessary to revise the PI-RADS scoring system concerning DCE in the transitional zone.

Cited by 64 publications

References 22 publications

Multiparametric MRI guidance in first-time prostate biopsies: what is the real benefit?

Multiparametric MRI guidance in first-time prostate biopsies: what is the real benefit?

Direct comparison of multiparametric magnetic resonance imaging (MRI) results with final histopathology in patients with proven prostate cancer in MRI/ultrasonography‐fusion biopsy

Evaluation of Prostate Imaging Reporting and Data System Classification in the Prediction of Tumor Aggressiveness in Targeted Magnetic Resonance Imaging/Ultrasound-Fusion Biopsy

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