Association Between Tumor Multifocality on Multi-parametric MRI and Detection of Clinically-Significant Prostate Cancer in Lesions with Prostate Imaging Reporting and Data System (PI-RADS) Score 4

Urology ◽  
2019 ◽  
Vol 134 ◽  
pp. 173-180
Author(s):  
Kamyar Ghabili ◽  
Matthew Swallow ◽  
Rachael L. Sherrer ◽  
Jamil S. Syed ◽  
Ghazal Khajir ◽  
...  
2021 ◽  
pp. 20201434
Author(s):  
Yasuyo Urase ◽  
Yoshiko Ueno ◽  
Tsutomu Tamada ◽  
Keitaro Sofue ◽  
Satoru Takahashi ◽  
...  

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.


2020 ◽  
Author(s):  
Loudong Zhang ◽  
Hua Zhu ◽  
Donghua Gu ◽  
Xiaodong Pan ◽  
bing zheng

Abstract Background: At present, there are various clinical regression models for predicting prostate cancer. But what about the diagnostic effectiveness of these models in different parameter ranges, and are the models applicable to everyone? This study aimed to study the influence of different levels of prostate-specific antigen (PSA) and Prostate Imaging Report and Data System version 2 (PI-RADS v2) scores on the regression model to predict clinically significant prostate cancer (csPCa).Methods: This retrospective study screened 251 patients from our hospital, who were divided into different groups. The regression model was established for each group to predict csPCa, and the effects of PSA and PI-RADS scores on each model were analyzed through the diagnostic effects of the model.Results: In patients with lower PSA scores, although the model was less sensitive than PSA, the AUC of the model was much greater. With the rise of PSA, the sensitivity of the model surpassed that of PSA, while the specificity became the opposite, and the AUC gap also gradually decreased. In the group with low PI-RADS score, the sensitivity and specificity of PI-RADS were lower than the model, and the gap was larger. Although the gap between the two gradually decreased with the increase of PI-RADS, the diagnostic efficiency of the model was still slightly larger than that of pure PI-RADS.Conclusion: As the PSA and PI-RADS v2 scores increase, the diagnostic advantages of the regression model will gradually decrease. However, for patients with low levels of PSA and PI-RADS scores,the regression model is less affected by PSA and PI-RADS, and can better utilize its clinical diagnostic advantages.


2021 ◽  
Vol 28 (2) ◽  
pp. 1294-1301
Author(s):  
Daiki Kato ◽  
Kaori Ozawa ◽  
Shinichi Takeuchi ◽  
Makoto Kawase ◽  
Kota Kawase ◽  
...  

This study aimed to determine the predictive value of the Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) based on biparametric magnetic resonance imaging (bpMRI) with combined target biopsy (TBx) and systematic biopsy (SBx) in patients with suspicion of having clinically significant prostate cancer (csPCa). In this retrospective study, we reviewed the clinical and pathological records of 184 consecutive patients who underwent bpMRI before prostate biopsy. We focused on patients with PI-RADS v2 scores ≥ 3. MRI was performed using a 3-Tesla clinical scanner with a 32-channel phased-array receiver coil. PI-RADS v2 was used to describe bpMRI findings based on T2-weighted imaging and diffusion-weighted imaging scores. The primary endpoint was the diagnostic accuracy rate of PI-RADS v2 based on bpMRI for patients with prostate cancer (PCa) who underwent combined TBx and SBx. A total of 104 patients were enrolled in this study. Combined TBx and SBx was significantly superior to either method alone for PCa detection in patients with suspicious lesions according to PI-RADS v2. TBx and SBx detected concordant csPCa in only 24.1% of the patients. In addition, the rate of increase in the Gleason score was similar between SBx (41.5%) and TBx (34.1%). The diagnostic accuracy of bpMRI is comparable to that of standard multiparametric MRI for the detection of csPCa. Moreover, combined TBx and SBx may be optimal for the accurate determination of csPCa diagnosis, the International Society of Urological Pathology grade, and risk classification.


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