Interobserver reproducibility of the PRECISE scoring system for prostate MRI on active surveillance: results from a two-centre pilot study

Giganti, Francesco; Pecoraro, Martina; Stavrinides, Vasilis; Stabile, Armando; Cipollari, Stefano; Sciarra, Alessandro; Kirkham, Alex; Allen, Clare; Punwani, Shonit; Emberton, Mark; Catalano, Carlo; Moore, Caroline M.; Panebianco, Valeria

doi:10.1007/s00330-019-06557-2

Cited by 27 publications

(14 citation statements)

References 24 publications

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“…23 In addition to this, a substantial reproducibility of the PRECISE scoring system has been recently shown between two expert radiologists, especially when data are pooled together according to the absence or presence of radiological progression, as in our study. 24 We acknowledge that the correlation with the PRECISE scoring system could be seen of limited value at present, as radiological progression is one of the drivers to active treatment in our AS cohort. Our initial results should be seen as a first attempt to explore the relationship between changes in lesion size on mpMRI and radiological changes by means of PRECISE score, as called for by the panellists who drafted the PRECISE recommendations.…”

Section: Discussionmentioning

confidence: 91%

Prostate cancer measurements on serial MRI during active surveillance: it’s time to be PRECISE

Giganti

Stavrinides

Stabile

et al. 2020

BJR

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Objective: The PRECISE criteria for reporting multiparametric MRI in patients on active surveillance (AS) for prostate cancer (PCa) score the likelihood of clinically significant change over time using a 1–5 scale, where 4 or 5 indicates radiological progression. According to the PRECISE recommendations, the index lesion size can be reported using different definitions of volume (planimetry or ellipsoid formula) or by measuring one or two diameters. We compared different measurements using planimetry as the reference standard and stratified changes according to the PRECISE scores. Methods: We retrospectively analysed 196 patients on AS with PCa confirmed by targeted biopsy who had two MR scans (baseline and follow-up). Lesions were measured on T2 weighted imaging (T2WI) according to all definitions. A PRECISE score was assessed for each patient. Results: The ellipsoid formula exhibited the highest correlation with planimetry at baseline (ρ = 0.97) and follow-up (ρ = 0.98) imaging, compared to the biaxial measurement and single maximum diameter. There was a significant difference (p < 0.001) in the yearly percentage volume change between radiological regression/stability (PRECISE 2–3) and progression (PRECISE 4–5) for planimetry (39.64%) and for the ellipsoid formula (46.78%). Conclusion: The ellipsoid formula could be used to monitor tumour growth during AS. Evidence of a significant yearly percentage volume change between radiological regression/stability (PRECISE 2-3) and progression (PRECISE 4-5) has been also observed. Advances in knowledge: The ellipsoid formula is a reasonable surrogate for planimetry in capturing tumour volume changes on T2WI in patients on imaging-led AS. This is also associated with radiological changes using the PRECISE recommendations.

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Section: Discussionmentioning

confidence: 91%

Prostate cancer measurements on serial MRI during active surveillance: it’s time to be PRECISE

Giganti

Stavrinides

Stabile

et al. 2020

BJR

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“…This variation in AS practice has been reflected in a recent consensus statement by the Prostate Cancer UK Expert Reference Group on AS, which reported significant variation in contemporary international guidelines, and in international and British practice [24]. There have been previous attempts, such as the PRECISE recommendation, to standardise mp-MRI reporting during AS based on consensus opinions [25][26][27][28]. However, the findings in this review would suggest up-take of these standards to be limited.…”

Section: Discussionmentioning

confidence: 92%

Can the Use of Serial Multiparametric Magnetic Resonance Imaging During Active Surveillance of Prostate Cancer Avoid the Need for Prostate Biopsies?—A Systematic Diagnostic Test Accuracy Review

Hettiarachchi

Geraghty

Rice

et al. 2021

European Urology Oncology

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“…Only a single radiologist, although highly experienced in prostate MR reporting, applied the PRECISE score in the whole cohort. However, we have recently demonstrated the high interobserver agreement of the PRECISE score between two expert radiologists in a multicentre study [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…As there are still no explicit recommendations on which PRECISE score should be considered the most representative when multiple scans are acquired, we used the highest PRECISE score for each patient during the study period in this analysis. [14,15] We applied the following interpretation to the PRECISE recommendations:…”

Section: Mri Analysis and Precise Score Assessmentmentioning

confidence: 99%

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Natural history of prostate cancer on active surveillance: stratification by MRI using the PRECISE recommendations in a UK cohort

et al. 2020

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Objectives The PRECISE recommendations for magnetic resonance imaging (MRI) in patients on active surveillance (AS) for prostate cancer (PCa) include repeated measurement of each lesion, and attribution of a PRECISE radiological progression score for the likelihood of clinically significant change over time. We aimed to compare the PRECISE score with clinical progression in patients who are managed using an MRI-led AS protocol. Methods A total of 553 patients on AS for low- and intermediate-risk PCa (up to Gleason score 3 + 4) who had two or more MRI scans performed between December 2005 and January 2020 were included. Overall, 2161 scans were retrospectively re-reported by a dedicated radiologist to give a PI-RADS v2 score for each scan and assess the PRECISE score for each follow-up scan. Clinical progression was defined by histological progression to ≥ Gleason score 4 + 3 (Gleason Grade Group 3) and/or initiation of active treatment. Progression-free survival was assessed using Kaplan-Meier curves and log-rank test was used to assess differences between curves. Results Overall, 165/553 (30%) patients experienced the primary outcome of clinical progression (median follow-up, 74.5 months; interquartile ranges, 53–98). Of all patients, 313/553 (57%) did not show radiological progression on MRI (PRECISE 1–3), of which 296/313 (95%) had also no clinical progression. Of the remaining 240/553 patients (43%) with radiological progression on MRI (PRECISE 4–5), 146/240 (61%) experienced clinical progression (p < 0.0001). Patients with radiological progression on MRI (PRECISE 4-5) showed a trend to an increase in PSA density. Conclusions Patients without radiological progression on MRI (PRECISE 1-3) during AS had a very low likelihood of clinical progression and many could avoid routine re-biopsy. Key Points • Patients without radiological progression on MRI (PRECISE 1–3) during AS had a very low likelihood of clinical progression and many could avoid routine re-biopsy. • Clinical progression was almost always detectable in patients with radiological progression on MRI (PRECISE 4–5) during AS. • Patients with radiological progression on MRI (PRECISE 4–5) during AS showed a trend to an increase in PSA density.

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Interobserver reproducibility of the PRECISE scoring system for prostate MRI on active surveillance: results from a two-centre pilot study

Cited by 27 publications

References 24 publications

Prostate cancer measurements on serial MRI during active surveillance: it’s time to be PRECISE

Prostate cancer measurements on serial MRI during active surveillance: it’s time to be PRECISE

Can the Use of Serial Multiparametric Magnetic Resonance Imaging During Active Surveillance of Prostate Cancer Avoid the Need for Prostate Biopsies?—A Systematic Diagnostic Test Accuracy Review

Natural history of prostate cancer on active surveillance: stratification by MRI using the PRECISE recommendations in a UK cohort

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