Assessing the validity of Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) scoring system in diagnosis of peripheral zone prostate cancer

Objective: We determined the sensitivity and specificity of multiparametric magnetic resonance imaging (MP-MRI) in detection of locally recurrent prostate cancer and extra prostatic extension in the post-radical radiotherapy setting. Histopathological reference standard was whole-mount prostatectomy specimens. We also assessed for any added value of the dynamic contrast enhancement (DCE) sequence in detection and staging of local recurrence. Methods: This was a single centre retrospective study. Participants were selected from a database of males treated with salvage prostatectomy for locally recurrent prostate cancer following radiotherapy. All underwent pre-operative prostate-specific antigen assay, positron emission tomography CT, MP-MRI and transperineal template prostate mapping biopsy prior to salvage prostatectomy. MP-MRI performance was assessed using both Prostate Imaging-Reporting and Data System v. 2 and a modified scoring system for the post-treatment setting. Results: 24 patients were enrolled. Using Prostate Imaging-Reporting and Data System v. 2, sensitivity, specificity, positive predictive value and negative predictive value was 64%, 94%, 98% and 36%. MP-MRI under staged recurrent cancer in 63%. A modified scoring system in which DCE was used as a co-dominant sequence resulted in improved diagnostic sensitivity (61%–76%) following subgroup analysis. Conclusion: Our results show MP-MRI has moderate sensitivity (64%) and high specificity (94%) in detecting radio-recurrent intraprostatic disease, though disease tends to be under quantified and under staged. Greater emphasis on dynamic contrast images in overall scoring can improve diagnostic sensitivity. Advances in knowledge: MP-MRI tends to under quantify and under stage radio-recurrent prostate cancer. DCE has a potentially augmented role in detecting recurrent tumour compared with the de novo setting. This has relevance in the event of any future modified MP-MRI scoring system for the irradiated gland.

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Comparison of quantitative apparent diffusion coefficient parameters with prostate imaging reporting and data system V2 assessment for detection of clinically significant peripheral zone prostate cancer

Abdominal Radiology ◽

10.1007/s00261-017-1297-y ◽

2017 ◽

Vol 43 (5) ◽

pp. 1237-1244 ◽

Cited By ~ 1

Author(s):

Elmira Hassanzadeh ◽

Francesco Alessandrino ◽

Olutayo I. Olubiyi ◽

Daniel I. Glazer ◽

Robert V. Mulkern ◽

...

Keyword(s):

Prostate Cancer ◽

Diffusion Coefficient ◽

Apparent Diffusion Coefficient ◽

Peripheral Zone ◽

Data System ◽

Prostate Imaging ◽

Apparent Diffusion ◽

Clinically Significant

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An integrated nomogram combining deep learning, Prostate Imaging–Reporting and Data System (PI-RADS) scoring, and clinical variables for identification of clinically significant prostate cancer on biparametric MRI: a retrospective multicentre study

The Lancet Digital Health ◽

10.1016/s2589-7500(21)00082-0 ◽

2021 ◽

Vol 3 (7) ◽

pp. e445-e454

Author(s):

Amogh Hiremath ◽

Rakesh Shiradkar ◽

Pingfu Fu ◽

Amr Mahran ◽

Ardeshir R Rastinehad ◽

...

Keyword(s):

Prostate Cancer ◽

Deep Learning ◽

Multicentre Study ◽

Data System ◽

Clinical Variables ◽

Prostate Imaging ◽

Clinically Significant

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Interobserver agreement of Prostate Imaging–Reporting and Data System (PI-RADS–v2)

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-020-00378-w ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Hala Maher Ahmed ◽

Ahmed Ebrahim Ebeed ◽

Ahmed Hamdy ◽

Mohamed Abou El-Ghar ◽

Ahmed Abdel Khalek Abdel Razek

Keyword(s):

Interobserver Agreement ◽

Imaging Modality ◽

Peripheral Zone ◽

Transitional Zone ◽

Data System ◽

3 Tesla ◽

Prostate Imaging ◽

Percent Agreement ◽

3 Tesla Mri

Abstract Background A retrospective study was conducted on 71 consecutive patients with suspected prostate cancer (PCa) with a mean age of 56 years and underwent mp-MRI of the prostate at 3 Tesla MRI. Two readers recognized all prostatic lesions, and each lesion had a score according to Prostate Imaging–Reporting and Data System version 2 (PI-RADS-v2). Purpose of the study To evaluate the interobserver agreement of PI-RADS-v2 in characterization of prostatic lesions using multiparametric MRI (mp-MRI) at 3 Tesla MRI. Results The overall interobserver agreement of PI-RADS-v2 for both zones was excellent (k = 0.81, percent agreement = 94.9%). In the peripheral zone (PZ) lesions are the interobserver agreement for PI-RADS II (k = 0.78, percent agreement = 83.9%), PI-RADS III (k = 0.66, percent agreement = 91.3 %), PI-RADS IV (k = 0.69, percent agreement = 93.5%), and PI-RADS V (k = 0.91, percent agreement = 95.7 %). In the transitional zone (TZ) lesions are the interobserver agreement for PI-RADS I (k = 0.98, percent of agreement = 96%), PI-RADS II (k = 0.65, percent agreement = 96%), PI-RADS III (k = 0.65, percent agreement = 88%), PI-RADS IV (k = 0.83, percent agreement = 96%), and PI-RADS V (k = 0.82, percent agreement = 92%). Conclusion We concluded that PI-RADS-v2 is a reliable and a reproducible imaging modality for the characterization of prostatic lesions and detection of PCa.

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Re: Risk of Clinically Significant Prostate Cancer Associated with Prostate Imaging Reporting and Data System Category 3 (Equivocal) Lesions Identified on Multiparametric Prostate MRI

The Journal of Urology ◽

10.1016/j.juro.2018.03.123 ◽

2018 ◽

Vol 200 (1) ◽

pp. 11-11

Author(s):

Cary Siegel

Keyword(s):

Prostate Cancer ◽

Data System ◽

Prostate Mri ◽

Prostate Imaging ◽

Multiparametric Prostate Mri ◽

Clinically Significant

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Evaluating the performance of clinical and radiological data in predicting prostate cancer in prostate imaging reporting and data system version 2.1 category 3 lesions of the peripheral and the transition zones

International Urology and Nephrology ◽

10.1007/s11255-021-03071-7 ◽

2021 ◽

Author(s):

Caterina Gaudiano ◽

Lorenzo Bianchi ◽

Beniamino Corcioni ◽

Francesca Giunchi ◽

Riccardo Schiavina ◽

...

Keyword(s):

Prostate Cancer ◽

Data System ◽

Transition Zones ◽

Prostate Imaging ◽

Radiological Data

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Comparison of prostate imaging reporting and data system v2.1 and 2 in transition and peripheral zones: evaluation of interreader agreement and diagnostic performance in detecting clinically significant prostate cancer

British Journal of Radiology ◽

10.1259/bjr.20201434 ◽

2021 ◽

pp. 20201434

Author(s):

Yasuyo Urase ◽

Yoshiko Ueno ◽

Tsutomu Tamada ◽

Keitaro Sofue ◽

Satoru Takahashi ◽

...

Keyword(s):

Prostate Cancer ◽

Diagnostic Performance ◽

Area Under The Curve ◽

Data System ◽

Transition Zones ◽

Prostate Imaging ◽

Institutional Review ◽

3.0 T ◽

Clinically Significant ◽

Interreader Agreement

Objectives: To evaluate the interreader agreement and diagnostic performance of the Prostate Imaging Reporting and Data System (PI-RADS) v2.1, in comparison with v2. Methods: Institutional review board approval was obtained for this retrospective study. Seventy-seven consecutive patients who underwent a prostate multiparametric magnetic resonance imaging at 3.0 T before radical prostatectomy were included. Four radiologists (two experienced uroradiologists and two inexperienced radiologists) independently scored eight regions [six peripheral zones (PZ) and two transition zones (TZ)] using v2.1 and v2. Interreader agreement was assessed using κ statistics. To evaluate diagnostic performance for clinically significant prostate cancer (csPC), area under the curve (AUC) was estimated. Results 228 regions were pathologically diagnosed as positive for csPC. With a cutoff ≥3, the agreement among all readers was better with v2.1 than v2 in TZ, PZ, or both zones combined (κ-value: TZ, 0.509 vs 0.414; PZ, 0.686 vs 0.568; both zones combined, 0.644 vs 0.531). With a cutoff ≥4, the agreement among all readers was also better with v2.1 than v2 in the PZ or both zones combined (κ-value: PZ, 0.761 vs 0.701; both zones combined, 0.756 vs 0.709). For all readers, AUC with v2.1 was higher than with v2 (TZ, 0.826–0.907 vs 0.788–0.856; PZ, 0.857–0.919 vs 0.853–0.902). Conclusions: Our study suggests that the PI-RADS v2.1 could improve the interreader agreement and might contribute to improved diagnostic performance compared with v2. Advances in knowledge: PI-RADS v2.1 has a potential to improve interreader variability and diagnostic performance among radiologists with different levels of expertise.

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