Prostate Cancer: PI-RADS Version 2 Helps Preoperatively Predict Clinically Significant Cancers

Abstract

Purpose To retrospectively analyze whether Prostate Imaging Reporting and Data System (PI-RADS) version 2 is helpful for the detection of clinically significant prostate cancer. Materials and Methods Institutional review board approved this retrospective study. A total of 425 patients with prostate cancer who had undergone magnetic resonance (MR) imaging and radical prostatectomy were included. Preoperative parameters such as prostate-specific antigen, biopsy Gleason score, greatest percentage of the core, percentage of the positive core number, and score at PI-RADS version 2 with MR imaging were investigated. Two independent readers performed PI-RADS scoring. Clinically significant prostate cancer was defined as follows: (a) Gleason score of 7 or greater, (b) tumor volume of 0.5 cm(3) or greater, or a (c) positive extracapsular extension or seminal vesicle invasion. The reference standard was based on review of surgical specimen. Logistic regression was conducted to determine which parameters are associated with the presence of clinically significant cancer. Interreader agreement (ie, score ≥4 or not) was investigated by using κ statistics. Results At univariate analysis, all of the preoperative parameters were significant for clinically significant prostate cancer (P < .05). However, multivariate analysis revealed that PI-RADS score was the only significant parameter for both readers (reader 1: odds ratio = 28.170, P = .002; reader 2: odds ratio = 5.474, P = .007). The interreader agreement was excellent for PI-RADS score of 4 or greater (weighted κ = 0.801; 95% confidence interval: 0.737, 0.865). Conclusion The use of PI-RADS version 2 may help preoperatively diagnose clinically significant prostate cancer. (©) RSNA, 2016.

Diagnostic Accuracy of a MR Protocol Acquired with and without Endorectal Coil for Detection of Prostate Cancer: A Multicenter Study

“…These results are comparable with our study, where sensitivity ranged between 0.85 and 0.97 with and 0.76 and 0.82 without the usage of an ERC, and demonstrate that images acquired without an ERC may be sufficient for the purpose of detection of prostate cancer. Inter- and intra-reader agreement in our study was within the range of previously published results [34,35,36,37] and did not differ between the two coil setups investigated.…”

Predictive role of PI-RADSv2 and ADC parameters in differentiating Gleason pattern 3 + 4 and 4 + 3 prostate cancer

“…PI-RADSv2 utilizes a 5 point scale to determine the likelihood of clinically significant PCa, and is based upon qualitative interpretation of DWI/ADC, dynamic contrast-enhanced MRI (DCE-MRI) and T2-weighted imaging (T2WI) [12]. PI-RADSv2 has shown to improve preoperative detection of clinically significant PCa, but there is scarce data regarding its predictive role in discriminating GP 3+4 from GP 4+3 PCa [12,22]. …”

Diagnostic Accuracy of Multiparametric Magnetic Resonance Imaging to Identify Clear Cell Renal Cell Carcinoma in cT1a Renal Masses

“…11 Given that the probability of ccRCC diagnosis is proportional to the added effect of individual parameters, a likelihood score based on those MRI parameters might provide a useful tool for patient management, as has been done with prostate cancer. 20,21 …”