Prospective comparison of PI‐RADS version 2 and qualitative in‐house categorization system in detection of prostate cancer

Abstract

1 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:1326-1335.

Prostate Imaging-Reporting and Data System Steering Committee: PI-RADS v2 Status Update and Future Directions

“…There are multiple distinguishing features between the imaging-only PI-RADS v2 system, other non-PI-RADS imaging systems, and clinicoradiologic Likert impressions [40][41][42][43][44][45], whose performance for disease detection has been reported in the literature [2,26,44,45]. It is important to note that PI-RADS v2 assessment categories are based on combinations of predefined mpMRI features, weighted for the likelihood of malignancy, to be evaluated in a specified order, separately for lesions in the PZ and TZ.…”

“…It is important to note that PI-RADS v2 assessment categories are based on combinations of predefined mpMRI features, weighted for the likelihood of malignancy, to be evaluated in a specified order, separately for lesions in the PZ and TZ. Other systems use additional non-PI-RADS imaging criteria (such as number of sequences on which abnormalities are visible and the scaled likelihood of extraprostatic extension [43]) or subjectively incorporate clinical factors such as family history, DRE findings, PSA, and PSAD to arrive at clinicoradiologic impressions of the likelihood of csPCa [36]. However, to promote standardization and reduce observer variability, PI-RADS v2 reduces flexibility in imaging interpretations.…”

“…This includes clinical recommendations on tissue sampling needs and methods according to mpMRI findings, and the use of mpMRI for selection of patients who are suitable for gland-sparing therapies such as focal ablation and AS. It is anticipated that the next major PI-RADS revision will be a multiyear endeavor requiring additional research data on PI-RADS criteria [43] and clinical usage. A variety of proposals for inclusion have been tabled, but the literature evidence for inclusion is highly variable to date.…”

Predicting Gleason Group Progression for Men on Prostate Cancer Active Surveillance: Role of a Negative Confirmatory Magnetic Resonance Imaging-Ultrasound Fusion Biopsy

“…The exception is a PI-RADS 4 lesion, which may have a lower cancer detection rate than a lesion with a moderate-high likelihood of PCa due to the incorporation of extraprostatic extension features. 16 The PI-RADS was not in use at the beginning of the study and, therefore, it was not used in this analysis.…”

Contrast Medium or No Contrast Medium for Prostate Cancer Diagnosis. That Is the Question

“…Although the role of DCE‐MRI within PI‐RADS v2.1 is limited to the characterization of category 3 lesions in the peripheral zone of the prostate gland, for other Likert systems the DCE‐MRI sequence is mandatory 12,14,35 for reasons of lesion detection, characterization, for biopsy planning, and for contingencies. Additionally within the PI‐RADS system, DCE‐MRI sequences can be used as a “back‐up” for readers with less experience or when there is insufficient image quality 4 .…”