Performance of Prostate Imaging Reporting and Data System Version 2.1 for Diagnosis of Prostate Cancer: A Systematic Review and <scp>Meta‐Analysis</scp>

Park, Kye Jin; Choi, Sang Hyun; Kim, Mi‐Hyun; Kim, Jeong Kon; Jeong, In Gab

doi:10.1002/jmri.27546

Cited by 59 publications

(52 citation statements)

References 29 publications

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“…The latter showed unbalanced high sensitivity and low specificity, in line with a recent meta-analysis on PI-RADSv2.1 accuracy (94 and 56% pooled sensitivity and specificity for a category ≥3 cut-off, respectively). 25 Combining category 4h and PSAD ≥0.10 ng/ml ml −1 as a trigger for biopsy was the strategy with the highest net benefit on decision analysis when the probability of csPCa was assumed to be 30 and 40%, that is, within the expected range of csPCa prevalence (28–49%, average 39%) in biopsy-naïve patients. 6 This was not the case for strategies adjusting for PSAD of 0.15 and 0.20 ng/ml ml −1 , for which category 3h or four showed comparable net benefit.…”

Section: Discussionmentioning

confidence: 99%

Comparison of different thresholds of PSA density for risk stratification of PI-RADSv2.1 categories on prostate MRI

Girometti

Giannarini

Panebianco

et al. 2021

The British Journal of Radiology

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Objectives: To compare the effect of different PSA density (PSAD) thresholds on the accuracy for clinically significant prostate cancer (csPCa) of the Prostate Imaging Reporting And Data System v.2.1 (PI-RADSv2.1). Methods: We retrospectively included 123 biopsy-naïve men who underwent multiparametric magnetic resonance imaging (mpMRI) and transperineal mpMRI-targeted and systematic prostate biopsy between April 2019 and October 2020. mpMRI, obtained on a 3.0T magnet with a PI-RADSv2.1-compliant protocol, was read by two radiologists (>1500/>500 mpMRI examinations). csPCa was defined as International Society of Urogenital Pathology grading group ≥2. Receiver operating characteristic analysis was used to calculate per-index lesion sensitivity, specificity, and area under the curve (AUC) of PI-RADSv.2.1 categories after adjusting for PSAD ≥0.10,≥0.15, and ≥0.20 ng/mL ml−1. Per-adjusted category cancer detection rate (CDR) was calculated, and decision analysis performed to compare PSAD-adjusted PI-RADSv.2.1 categories as a biopsy trigger. Results: csPCa prevalence was 43.9%. PSAD-adjustment increased the CDR of PI-RADSv2.1 category 4. Sensitivity/specificity/AUC were 92.6%/53.6%/0.82 for unadjusted PI-RADS, and 85.2%/72.4%/0.84, 62.9%/85.5%/0.83, and 92.4%/53.6%/0.82 when adjusting PI-RADS categories for a 0.10, 0.15, and 0.20 ng/ml ml−1 PSAD threshold, respectively. Triggering biopsy for PI-RADS four lesions and PSAD ≥0.10 ng/mL ml−1 was the strategy with greatest net benefit at 30 and 40% risk probability (0.307 and 0.271, respectively). Conclusions: PI-RADSv2.1 category four with PSAD ≥0.10 ng/mL ml−1 was the biopsy-triggering cut-off with the highest net benefit in the range of expected prevalence for csPCa. Advances in knowledge: 0.10 ng/mL ml−1 is the PSAD threshold with higher clinical utility in stratifying the risk for prostate cancer of PI-RADSv.2.1 categories.

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Section: Discussionmentioning

confidence: 99%

Comparison of different thresholds of PSA density for risk stratification of PI-RADSv2.1 categories on prostate MRI

Girometti

Giannarini

Panebianco

et al. 2021

The British Journal of Radiology

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“…Byun et al 28 demonstrated that PI‐RADS v2.1 shows higher sensitivity and specificity than v2, even though the difference was not statistically significant. Recently, Park et al 29 published a systematic review and meta‐analysis on the evaluation of the diagnostic performance of PI‐RADS v2.1 in comparison with v2, on a cohort of 1248 patients with 1406 lesions from 10 eligible selected articles. Authors showed a pooled sensitivity and specificity of PI‐RADS v2.1 of 87% (95% CI, 82–91%) and 74% (95% CI, 63–82%), respectively.…”

Section: The Prostate Imaging‐reporting and Data System (Pi‐rads) Scorementioning

confidence: 99%

“…However, the results are controversial. For example, some researchers have reported that SARS-CoV-2 was not detected in the male reproductive tract, [25][26][27][28][29][30][31][32][33][34] while others reported that SARS-CoV-2 RNA was found in the semen or testes of COVID-19 patients. 35,36 There are also unknown factors regarding COVID-19 and male reproduction.…”

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confidence: 99%

The future direction of imaging in prostate cancer: MRI with or without contrast injection

et al. 2021

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Background: Multiparametric MRI (mpMRI) is the "state of the art" management tool for patients with suspicion of prostate cancer (PCa). The role of non-contrast MRI is investigated to move toward a more personalized, less invasive, and highly costeffective PCa diagnostic workup.Objective: To perform a non-systematic review of the existing literature to highlight strength and flaws of performing non-contrast MRI, and to provide a critical overview of the international scientific production on the topic. Materials and Methods:Online databases (Medline, PubMed, and Web of Science) were searched for original articles, systematic review and meta-analysis, and expert opinion papers.Results: Several investigations have shown comparable diagnostic accuracy of biparametric (bpMRI) and mpMRI for the detection of PCa. The advantage of abandoning contrast-enhanced sequences improves operational logistics, lowering costs, acquisition time, and side effects. The main limitations of bpMRI are that most studies comparing non-contrast with contrast MRI come from centers with high expertise that might not be reproducible in the general community setting; besides, reduced protocols might be insufficient for estimation of the intra-and extra-prostatic extension and regional disease. The mentioned observations suggest that low-quality mpMRI for the general population might represent the main shortage to overcome.Discussion: Non-contrast MRI future trends are likely represented by PCa screening and the application of artificial intelligence (AI) tools. PCa screening is still a controversial topic; bpMRI has become one of the most promising diagnostic applications, as it is a more sensitive test for PCa early detection, compared to serum PSA level test. Also, AI applications and radiomic have been the object of several studies investigating PCa detection using bpMRI, showing encouraging results. Conclusion:Today, the accessibility to MRI for early detection of PCa is a priority.Results from prospective, multicenter, multireader, and paired validation studies are needed to provide evidence supporting its role in the clinical practice.

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“…In 2012, the European Society of Urogenital Radiology (ESUR) introduced Prostate Imaging Reporting and Data System (PI-RADS) for performing, interpreting, and reporting the PCa with multiparametric MRI (mpMRI) (11)(12)(13), which was widely applied in clinical practice (14)(15)(16). However, for localized advantage PCa of EPE, the ESUR PI-RADS demonstrated moderate diagnostic accuracy, mainly depending on radiologists' own experience and short of reproducibility (17).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Performance of Extraprostatic Extension Grading System for Detection of Extraprostatic Extension in Prostate Cancer: A Diagnostic Systematic Review and Meta-Analysis

Shang

et al. 2022

Front. Oncol.

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PurposeTo evaluate the diagnostic performance of the extraprostatic extension (EPE) grading system for detection of EPE in patients with prostate cancer (PCa).Materials and MethodsWe performed a literature search of Web of Science, MEDLINE (Ovid and PubMed), Cochrane Library, EMBASE, and Google Scholar to identify eligible articles published before August 31, 2021, with no language restrictions applied. We included studies using the EPE grading system for the prediction of EPE, with histopathological results as the reference standard. The pooled sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR−), and diagnostic odds ratio (DOR) were calculated with the bivariate model. Quality assessment of included studies was performed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool.ResultsA total of 4 studies with 1,294 patients were included in the current systematic review. The pooled sensitivity and specificity were 0.82 (95% CI 0.76–0.87) and 0.63 (95% CI 0.51–0.73), with the area under the hierarchical summary receiver operating characteristic (HSROC) curve of 0.82 (95% CI 0.79–0.85). The pooled LR+, LR−, and DOR were 2.20 (95% CI 1.70–2.86), 0.28 (95% CI 0.22–0.36), and 7.77 (95% CI 5.27–11.44), respectively. Quality assessment for included studies was high, and Deeks’s funnel plot indicated that the possibility of publication bias was low (p = 0.64).ConclusionThe EPE grading system demonstrated high sensitivity and moderate specificity, with a good inter-reader agreement. However, this scoring system needs more studies to be validated in clinical practice.

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Performance of Prostate Imaging Reporting and Data System Version 2.1 for Diagnosis of Prostate Cancer: A Systematic Review and Meta‐Analysis

Cited by 59 publications

References 29 publications

Comparison of different thresholds of PSA density for risk stratification of PI-RADSv2.1 categories on prostate MRI

Comparison of different thresholds of PSA density for risk stratification of PI-RADSv2.1 categories on prostate MRI

The future direction of imaging in prostate cancer: MRI with or without contrast injection

Diagnostic Performance of Extraprostatic Extension Grading System for Detection of Extraprostatic Extension in Prostate Cancer: A Diagnostic Systematic Review and Meta-Analysis

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