Interreader Variability of Prostate Imaging Reporting and Data System Version 2 in Detecting and Assessing Prostate Cancer Lesions at Prostate MRI

Greer, Matthew D.; Shih, Joanna H.; Lay, Nathan; Barrett, Tristan; Bittencourt, Leonardo Kayat; Borofsky, Samuel; Kabakus, Ismail; Law, Yan Mee; Marko, Jamie; Shebel, Haytham; Merino, María J.; Wood, Bradford J.; Pinto, Peter A.; Summers, Ronald M.; Choyke, Peter L.; Türkbey, Barış

doi:10.2214/ajr.18.20536

Cited by 95 publications

(75 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Poor agreement in PI-RADSv2 score 3 across readers of all experience levels was previously reported. 25 Less experienced readers were more likely to assign detected lesions to category 3 26 and specificity to predict csPCa using a threshold of 3 or greater was 39%. 3 Although csPCa is detected in approximately 16% of MRI targeted biopsies of PI-RADSv2 score 3 lesions in patients with prior negative biopsy, 27 previous studies did not indicate a statistically significant difference between MRI targeted biopsies compared to systematic TRUS guided biopsies in this subgroup.…”

Section: Discussionmentioning

confidence: 93%

Reducing Unnecessary Prostate Multiparametric Magnetic Resonance Imaging by Using Clinical Parameters to Predict Negative and Indeterminate Findings

et al. 2020

View full text Add to dashboard Cite

Purpose: We sought to develop a triage strategy to reduce negative and indeterminate multiparametric magnetic resonance imaging scans in patients at risk for prostate cancer. Materials and Methods: In this retrospective study we evaluated 865 patients with no prior prostate cancer diagnosis who underwent prostate multiparametric magnetic resonance imaging between 2009 and 2017. Age, prostate volume, prostate specific antigen and prostate specific antigen density were assessed as predictors of positive multiparametric magnetic resonance imaging, defined as PI-RADSÔ (Prostate Imaging Reporting and Data System) version 2/Likert score 4 or greater. The cohort was split into a training cohort of 605 patients and a validation cohort of 260. The optimal threshold to rule out positive multiparametric magnetic resonance imaging was chosen to achieve a negative predictive value greater than 90%. Results: All clinical variables were significant predictors of positive multiparametric magnetic resonance imaging (p <0.05). Prostate specific antigen density outperformed other parameters in diagnostic accuracy and did not significantly differ compared to a multivariate model (AUC[0.74 vs 0.75). At prostate specific antigen density greater than 0.078 ng/ml 2 sensitivity, specificity, positive and negative predictive values were 94%, 29%, 22% and 95%, respectively, resulting in 25% fewer scans (64 of 260). In the multivariate model sensitivity, specificity, positive and negative predictive values were 85%, 32%, 22% and 91%, respectively, resulting in 29% fewer scans (75 of 260). Biopsies in men who would not have undergone multiparametric magnetic resonance imaging according to our proposed strategies revealed 2 clinically significant prostate cancers using prostate specific antigen density and 1 using the multivariate model. Conclusions: In patients at risk for prostate cancer applying a multivariate prediction model or a prostate specific antigen density cutoff of 0.078 ng/ml 2

show abstract

Section: Discussionmentioning

confidence: 93%

Reducing Unnecessary Prostate Multiparametric Magnetic Resonance Imaging by Using Clinical Parameters to Predict Negative and Indeterminate Findings

et al. 2020

View full text Add to dashboard Cite

show abstract

“…However, in a similar manner to Prostate Imaging Reporting and Data System (PI-RADS) and Likert scoring systems [9][10][11][12][13][14], formal investigations of the inter-reader reproducibility of the PRECISE criteria are also needed to confirm that such recommendations can be universally recognised and applied. Thus, we conducted this study at two academic institutions (University College London (UCL) and Sapienza) to investigate the interobserver reproducibility of the PRECISE recommendations between two experienced radiologists, using scans from different MR machines and patient cohorts.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

View full text Add to dashboard Cite

Objectives We aimed to determine the interobserver reproducibility of the Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) criteria for magnetic resonance imaging in patients on active surveillance (AS) for prostate cancer (PCa) at two different academic centres. Methods The PRECISE criteria score the likelihood of clinically significant change over time. The system is a 1-to-5 scale, where 1 or 2 implies regression of a previously visible lesion, 3 denotes stability and 4 or 5 indicates radiological progression. A retrospective analysis of 80 patients (40 from each centre) on AS with a biopsyconfirmed low-or intermediate-risk PCa (i.e. ≤ Gleason 3 + 4 and prostate-specific antigen ≤ 20 ng/ml) and ≥ 2 prostate MR scans was performed. Two blinded radiologists reported all scans independently and scored the likelihood of radiological change (PRECISE score) from the second scan onwards. Cohen's κ coefficients and percent agreement were computed. Results Agreement was substantial both at a per-patient and a per-scan level (κ = 0.71 and 0.61; percent agreement = 79% and 81%, respectively) for each PRECISE score. The agreement was superior (κ = 0.83 and 0.67; percent agreement = 90% and 91%, respectively) when the PRECISE scores were grouped according to the absence/presence of radiological progression (PRECISE 1-3 vs 4-5). Higher inter-reader agreement was observed for the scans performed at University College London (UCL) (κ = 0.81 vs 0.55 on a per-patient level and κ = 0.70 vs 0.48 on a per-scan level, respectively). The discrepancies between institutions were less evident for percent agreement (80% vs 78% and 86% vs 75%, respectively). Conclusions Expert radiologists achieved substantial reproducibility for the PRECISE scoring system, especially when data were pooled together according to the absence/presence of radiological progression (PRECISE 1-3 vs 4-5).

show abstract

“…The qualitative nature of the components of the PI‐RADSv2, which are mostly the same in PI‐RADSv2.1, has resulted in a range of reported sensitivity and specificity . To address this variation, multiple studies have evaluated the interreader agreement for PI‐RADSv2, mostly showing moderate agreement for lesion level final scoring . However, we have to ask the questions: Which parts of the system are most challenging for readers?…”

mentioning

confidence: 99%

“…3 To address this variation, multiple studies have evaluated the interreader agreement for PI-RADSv2, mostly showing moderate agreement for lesion level final scoring. [4][5][6] However, we have to ask the questions: Which parts of the system are most challenging for readers? And what should be done to have a more standardized interpretation?…”

mentioning

confidence: 99%

“…Although some previous studies have selected the readers from different centers to eliminate experience bias, they have shown similar results. 4,5 Finally, the most important role of MRI is to maximize detection of clinically significant PCa lesions (csPCa), as these high-grade tumors behave more aggressively and show more aggressive features on T 2 , DWI, and DCE. Generally, PI-RADS category 3 lesions are low-risk for csPCa; however, these lesions are usually biopsied at most centers.…”

mentioning

confidence: 99%

See 1 more Smart Citation

re: Interobserver Agreement of PI‐RADS v. 2 Lexicon Among Radiologists With Different Levels of Experience

Mirak

Raman

2019

Magnetic Resonance Imaging

View full text Add to dashboard Cite

show abstract

Interreader Variability of Prostate Imaging Reporting and Data System Version 2 in Detecting and Assessing Prostate Cancer Lesions at Prostate MRI

Cited by 95 publications

References 27 publications

Reducing Unnecessary Prostate Multiparametric Magnetic Resonance Imaging by Using Clinical Parameters to Predict Negative and Indeterminate Findings

Reducing Unnecessary Prostate Multiparametric Magnetic Resonance Imaging by Using Clinical Parameters to Predict Negative and Indeterminate Findings

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

re: Interobserver Agreement of PI‐RADS v. 2 Lexicon Among Radiologists With Different Levels of Experience

Contact Info

Product

Resources

About