Prostate cancer detection with biparametric magnetic resonance imaging (bpMRI) by readers with different experience: performance and comparison with multiparametric (mpMRI)

Gatti, Marco; Faletti, Riccardo; Calleris, Giorgio; Giglio, Jacopo; Berzovini, Claudio; Gentile, Francesco; Marra, Giancarlo; Misischi, Francesca; Molinaro, Luca; Bergamasco, Laura; Gontero, Paolo; Papotti, Mauro; Fonio, Paolo

doi:10.1007/s00261-019-01934-3

Cited by 94 publications

(64 citation statements)

References 25 publications

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“…Previous studies using PI-RADS v2 assessment found κ values that were lower than those found in our study [15,17,27]. However, since the κ values depend on many factors (including the prevalence of disease) [28], it makes no sense to compare κ value obtained in different studies.…”

Section: Discussioncontrasting

confidence: 91%

“…Moreover, the effects of reader experience on diagnostic performance, inter-observer, and inter-method agreement were not examined. Gatti et al [17] have found that the omission of DCE from mpMRI protocol does not affect PI-RADS v2 diagnostic performance only when readers are experts, affecting ROC analysis statistics.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, further studies have investigated the role of contrast injection in the PCa detection, when comparing biparametric MRI protocols (bpMRI) without DCE to mpMRI [13]. Moreover, several studies investigated PI-RADS v2 performances that were related to inter-reader variability and diagnostic accuracy in the detection of PCa and CS-PCa, also related to a less invasive bpMRI protocol [14][15][16][17][18]. Although the demonstrated improvements compared to the first version, especially in terms of standardization, diagnostic accuracy, and reproducibility [9,10], several inconsistencies, limitations, and conflicting results have been reported [14][15][16][17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

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Assessment of DCE Utility for PCa Diagnosis Using PI-RADS v2.1: Effects on Diagnostic Accuracy and Reproducibility

et al. 2020

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The role of dynamic contrast-enhanced-MRI (DCE-MRI) for Prostate Imaging-Reporting and Data System (PI-RADS) scoring is a controversial topic. In this retrospective study, we aimed to measure the added value of DCE-MRI in combination with T2-weighted (T2W) and diffusion-weighted imaging (DWI) using PI-RADS v2.1, in terms of reproducibility and diagnostic accuracy, for detection of prostate cancer (PCa) and clinically significant PCa (CS-PCa, for Gleason Score ≥ 7). 117 lesions in 111 patients were identified as suspicion by multiparametric MRI (mpMRI) and addressed for biopsy. Three experienced readers independently assessed PI-RADS score, first using biparametric MRI (bpMRI, including DWI and T2W), and then multiparametric MRI (also including DCE). The inter-rater and inter-method agreement (bpMRI- vs. mpMRI-based scores) were assessed by Cohen’s kappa (κ). Receiver operating characteristics (ROC) analysis was performed to evaluate the diagnostic accuracy for PCa and CS-PCa detection among the two scores. Inter-rater agreement was excellent for the three pairs of readers (κ ≥ 0.83), while the inter-method agreement was good (κ ≥ 0.73). Areas under the ROC curve (AUC) showed similar high-values (0.8 ≤ AUC ≤ 0.85). The reproducibility of PI-RADS v2.1 scoring was comparable and high among readers, without relevant differences, depending on the MRI protocol used. The inclusion of DCE did not influence the diagnostic accuracy.

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Section: Discussioncontrasting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Assessment of DCE Utility for PCa Diagnosis Using PI-RADS v2.1: Effects on Diagnostic Accuracy and Reproducibility

et al. 2020

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“…For example, current approaches to early detection of cancer are increasingly relying on the discriminative ability of diagnostic tests using a combination of biomarkers. This approach has recently been leveraged to detect prostate cancer 32 and neurological disorders 33 using multiparametric MRI such as T 1 ‐, T 2 ‐ and diffusion‐weighted MRI. These previously successful efforts have motivated the MRI‐biomarker‐based multivariate analysis applied in the current study.…”

Section: Discussionmentioning

confidence: 99%

Multivariate use of MRI biomarkers to classify histologically confirmed necrosis in symptomatic total hip arthroplasty

Sherafati

Bauer

Potter

et al. 2020

Journal Orthopaedic Research

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The failure of total hip arthroplasty (THA) is commonly associated with the necrosis of the periprosthetic tissue. To date, there is no established method to noninvasively quantify the progression of such necrosis. Magnetic resonance imaging (MRI) of soft tissues near implants has undergone a recent renaissance due to the development of multispectral metal‐artifact reduction techniques. Advanced analysis of multispectral MRI has been shown capable of detecting small magnetism effects of metallic debris in periprosthetic tissue. The purpose of this study is to demonstrate the diagnostic utility of these MRI‐based tissue‐magnetism signatures. Together with morphological MRI metrics, such as synovial volume and thickness, these measurements are utilized as biomarkers to noninvasively detect soft‐tissue necrosis in symptomatic THA patients (N=78). All subjects underwent an advanced MRI scan before revision surgery and tissue biopsies utilized for necrosis grading. Statistical analyses demonstrated a weak, but significant positive correlation (P = .04) between MRI magnetism signatures and necrosis scores, while indicating no meaningful association between the latter and serum cobalt and chromium ion levels. Receiver‐operating characteristic (ROC) analyses were then performed based on uni‐ and multivariate logistic regression models utilizing the measured MRI biomarkers as predictors of severe necrosis. The area under the curve of the ROC plots for MRI biomarkers as combined predictors were found to be 0.70 and 0.84 for cross‐validation and precision‐recall tests, respectively.

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“…There are scarce data that show a learning curve effect for mpMRI, the effect of a dedicated reader education program on PCa detection and diagnostic confidence and the effect of an online interactive case-based interpretation program [21][22][23][24]. Moreover, experienced urogenital radiologists show higher inter-reader agreement and better area under the receiver operating curve (AUC) characteristics as to radiologists with lower levels of experience [25][26][27][28][29]. In a relatively small sample size study, the AUC seems to remain stable after reading 300 cases but is significantly lower in readers who have read only 100 cases [27].…”

Section: Experience and Training Centresmentioning

confidence: 99%

Focus on the Quality of Prostate Multiparametric Magnetic Resonance Imaging: Synopsis of the ESUR/ESUI Recommendations on Quality Assessment and Interpretation of Images and Radiologists’ Training

et al. 2020

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Objectives This study aims to define consensus-based criteria for acquiring and reporting prostate MRI and establishing prerequisites for image quality. Methods A total of 44 leading urologists and urogenital radiologists who are experts in prostate cancer imaging from the European Society of Urogenital Radiology (ESUR) and EAU Section of Urologic Imaging (ESUI) participated in a Delphi consensus process. Panellists completed two rounds of questionnaires with 55 items under three headings: image quality assessment, interpretation and reporting, and radiologists' experience plus training centres. Of 55 questions, 31 were rated for agreement on a 9-point scale, and 24 were multiple-choice or open. For agreement items, there was consensus agreement with an agreement ≥ 70% (score 7-9) and disagreement of ≤ 15% of the panellists. For the other questions, a consensus was considered with ≥ 50% of votes. Results Twenty-four out of 31 of agreement items and 11/16 of other questions reached consensus. Agreement statements were (1) reporting of image quality should be performed and implemented into clinical practice; (2) for interpretation performance, radiologists should use self-performance tests with histopathology feedback, compare their interpretation with expert-reading and use external performance assessments; and (3) radiologists must attend theoretical and hands-on courses before interpreting prostate MRI. Limitations are that the results are expert opinions and not based on systematic reviews or meta-analyses. There was no consensus on outcomes statements of prostate MRI assessment as quality marker. Conclusions An ESUR and ESUI expert panel showed high agreement (74%) on issues improving prostate MRI quality. Checking and reporting of image quality are mandatory. Prostate radiologists should attend theoretical and hands-on courses, followed by supervised education, and must perform regular performance assessments. Key Points • Multi-parametric MRI in the diagnostic pathway of prostate cancer has a well-established upfront role in the recently updated European Association of Urology guideline and American Urological Association recommendations. • Suboptimal image acquisition and reporting at an individual level will result in clinicians losing confidence in the technique and returning to the (non-MRI) systematic biopsy pathway. Therefore, it is crucial to establish quality criteria for the acquisition and reporting of mpMRI. • To ensure high-quality prostate MRI, experts consider checking and reporting of image quality mandatory. Prostate radiologists must attend theoretical and hands-on courses, followed by supervised education, and must perform regular self-and external performance assessments. Maarten de Rooij and Bas Israël contributed equally to this work.

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Prostate cancer detection with biparametric magnetic resonance imaging (bpMRI) by readers with different experience: performance and comparison with multiparametric (mpMRI)

Cited by 94 publications

References 25 publications

Assessment of DCE Utility for PCa Diagnosis Using PI-RADS v2.1: Effects on Diagnostic Accuracy and Reproducibility

Assessment of DCE Utility for PCa Diagnosis Using PI-RADS v2.1: Effects on Diagnostic Accuracy and Reproducibility

Multivariate use of MRI biomarkers to classify histologically confirmed necrosis in symptomatic total hip arthroplasty

Focus on the Quality of Prostate Multiparametric Magnetic Resonance Imaging: Synopsis of the ESUR/ESUI Recommendations on Quality Assessment and Interpretation of Images and Radiologists’ Training

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