Comparison of diagnostic performance and inter-reader agreement between PI-RADS v2.1 and PI-RADS v2: systematic review and meta-analysis

2021 ◽  
pp. 20210509
Author(s):  
Chau Hung Lee ◽  
Balamurugan Vellayappan ◽  
Cher Heng Tan
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
B Value ◽  
High B Value ◽  
Lower Specificity ◽  
Clinically Significant ◽  
Sensitivity Specificity

Objectives: To perform a systematic review and meta-analysis comparing diagnostic performance and inter reader agreement between PI-RADS v. 2.1 and PI-RADS v. 2 in the detection of clinically significant prostate cancer (csPCa). Methods: A systematic review was performed, searching the major biomedical databases (Medline, Embase, Scopus), using the keywords “PIRADS 2.1” or “PI RADS 2.1” or “PI-RADS 2.1”. Studies reporting on head-to-head diagnostic comparison between PI-RADS v. 2.1 and v. 2 were included. Pooled sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were compared between PI-RADS v. 2.1 and v. 2. Summary receiver operator characteristic graphs were plotted. Analysis was performed for whole gland, and pre-planned subgroup analysis was performed by tumour location (whole gland vs transition zone (TZ)), high b-value DWI (b-value ≥1400 s/mm2), and reader experience (<5 years vs ≥5 years with prostate MRI interpretation). Inter-reader agreement and pooled rates of csPCa for PI-RADS 1–3 lesions were compared between PI-RADS v. 2.1 and v. 2. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool v. 2 (QUADAS-2). Results: Eight studies (1836 patients, 1921 lesions) were included. Pooled specificity for PI-RADS v. 2.1 was significantly lower than PI-RADS v. 2 for whole gland (0.62 vs 0.66, p = 0.02). Pooled sensitivities, PPVs and NPVs were not significantly different (p = 0.17, 0.31, 0.41). Pooled specificity for PI-RADS v. 2.1 was significantly lower than PI-RADS v. 2 for TZ only (0.67 vs 0.72, p = 0.01). Pooled sensitivities, PPVs and NPVs were not significantly different (p = 0.06, 0.36, 0.17). Amongst studies utilising diffusion-weighted imaging with highest b-value of ≥1400 s/mm2, pooled sensitivities, specificities, PPVs and NPVs were not significantly different (p = 0.52, 0.4, 0.5, 0.47). There were no significant differences in pooled sensitivities, specificities, PPVs and NPVs between PI-RADS v. 2.1 and PI-RADS v. 2 for less-experienced readers (p = 0.65, 0.37, 0.65, 0.81) and for more experienced readers (p = 0.57, 0.90, 0.91, 0.65). For PI-RADS v. 2.1 alone, there were no significant differences in pooled sensitivity, specificity, PPV and NPV between less and more experienced readers (p = 0.38, 0.70, 1, 0.48). Inter-reader agreement was moderate to substantial for both PI-RADS v. 2.1 and v. 2. There were no significant differences between pooled csPCa rates between PI-RADS v. 2.1 and v. 2 for PI-RADS 1–2 lesions (6.6% vs  7.3%, p = 0.53), or PI-RADS 3 lesions (24.1% vs  26.8%, p = 0.28). Conclusions: Diagnostic performance and inter-reader agreement for PI-RADS v. 2.1 is comparable to PI-RADS v. 2, however the significantly lower specificity of PI-RADS v. 2.1 may result in increased number of unnecessary biopsies. Advances in knowledge: 1. Compared to PI-RADS v. 2, PI-RADS v. 2.1 has a non-significantly higher sensitivity but a significantly lower specificity for detection of clinically significant prostate cancer. 2. PI-RADS v. 2.1 could potentially result in considerable increase in number of negative targeted biopsy rates for PI-RADS 3 lesions, which could have been potentially avoided.

scholarly journals MP24-19 NEGATIVE PREDICTIVE VALUE OF MULTI-PARAMETRIC MRI IN DETECTION OF CLINICALLY SIGNIFICANT PROSTATE CANCER: A SYSTEMATIC REVIEW AND META-ANALYSIS

2019 ◽  
Vol 201 (Supplement 4) ◽  
Author(s):  
Niranjan Sathianathen* ◽  
Altan Omer ◽  
Caroline Moore ◽  
Veerapan Kasivisvanathan ◽  
Roderick van den Bergh ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Meta Analysis ◽  
Clinically Significant

scholarly journals The Value of Contrast-Enhanced Ultrasound (CEUS) in Differentiating Testicular Masses: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 (19) ◽  
pp. 8990
Author(s):  
Antonio Tufano ◽  
Rocco Simone Flammia ◽  
Luca Antonelli ◽  
Rocco Minelli ◽  
Giorgio Franco ◽  
...  
Keyword(s):  
Systematic Review ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
Contrast Enhanced Ultrasound ◽  
Summary Receiver Operating Characteristic ◽  
Diagnostic Modality ◽  
Contrast Enhanced ◽  
Meta Analyses ◽  
Sensitivity Specificity

Ultrasound (US) still represents the mainstay of scrotal imaging. However, contrast-enhanced ultrasound (CEUS) is a relatively novel, but increasingly utilized diagnostic modality. In consequence, we performed a systematic review (SR) and pooled meta-analysis to investigate the diagnostic performance of CEUS in the evaluation of testicular masses (TM). A SR up to June 2021 was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The diagnostic performance of CEUS was evaluated basing on two different endpoints: neoplastic vs. non-neoplastic and malignant vs. benign TM. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) from eligible studies were pooled and summary receiver operating characteristic (SROC) curves were constructed for each endpoint. Overall, six qualified studies were deemed suitable for this meta-analysis. Diagnostic performance of CEUS showed an accuracy of 0.96 in detecting neoplastic masses (sensitivity of 0.89, PPV of 0.85, specificity of 0.62, and NPV of 0.69) and an accuracy of 0.96 in detecting malignant masses (sensitivity of 0.86, PPV of 0.73, specificity of 0.87, and NPV of 0.91). Taken together, CEUS may represent a promising minimally invasive diagnostic tool for characterization of TM, since it allows clinicians to identify neoplastic lesions and exclude malignant tumor.

scholarly journals The Primacy of High B-Value 3T-DWI Radiomics in the Prediction of Clinically Significant Prostate Cancer

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 739
Author(s):  
Alessandro Bevilacqua ◽  
Margherita Mottola ◽  
Fabio Ferroni ◽  
Alice Rossi ◽  
Giampaolo Gavelli ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Quantitative Imaging ◽  
B Value ◽  
Support Vector ◽  
Svm Classifier ◽  
Primary Role ◽  
High B Value ◽  
Wilcoxon Rank Sum Test ◽  
Apparent Diffusion ◽  
Clinically Significant

Predicting clinically significant prostate cancer (csPCa) is crucial in PCa management. 3T-magnetic resonance (MR) systems may have a novel role in quantitative imaging and early csPCa prediction, accordingly. In this study, we develop a radiomic model for predicting csPCa based solely on native b2000 diffusion weighted imaging (DWIb2000) and debate the effectiveness of apparent diffusion coefficient (ADC) in the same task. In total, 105 patients were retrospectively enrolled between January–November 2020, with confirmed csPCa or ncsPCa based on biopsy. DWIb2000 and ADC images acquired with a 3T-MRI were analyzed by computing 84 local first-order radiomic features (RFs). Two predictive models were built based on DWIb2000 and ADC, separately. Relevant RFs were selected through LASSO, a support vector machine (SVM) classifier was trained using repeated 3-fold cross validation (CV) and validated on a holdout set. The SVM models rely on a single couple of uncorrelated RFs (ρ < 0.15) selected through Wilcoxon rank-sum test (p ≤ 0.05) with Holm–Bonferroni correction. On the holdout set, while the ADC model yielded AUC = 0.76 (95% CI, 0.63–0.96), the DWIb2000 model reached AUC = 0.84 (95% CI, 0.63–0.90), with specificity = 75%, sensitivity = 90%, and informedness = 0.65. This study establishes the primary role of 3T-DWIb2000 in PCa quantitative analyses, whilst ADC can remain the leading sequence for detection.

Clinical impact of ultra-high b-value (3000 s/mm2) diffusion-weighted magnetic resonance imaging in prostate cancer at 3T: comparison with b-value of 2000 s/mm2

2021 ◽  
pp. 20210465
Author(s):  
Tsutomu Tamada ◽  
Ayumu Kido ◽  
Yu Ueda ◽  
Mitsuru Takeuchi ◽  
Takeshi Fukunaga ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diagnostic Performance ◽  
Signal To Noise Ratio ◽  
B Value ◽  
Single Shot ◽  
Signal To Noise ◽  
High B Value ◽  
Diffusion Weighted ◽  
Significant Difference ◽  
Noise Ratio

Objective: High b-value diffusion-weighted imaging (hDWI) with a b-value of 2000 s/mm2 provides insufficient image contrast between benign and malignant tissues and an overlap of apparent diffusion coefficient (ADC) between Gleason grades (GG) in prostate cancer (PC). We compared image quality, PC detectability, and discrimination ability for PC aggressiveness between ultra-high b-value DWI (uhDWI) of 3000 s/mm2 and hDWI. Methods: The subjects were 49 patients with PC who underwent 3T multiparametric MRI. Single-shot echo-planar DWI was acquired with b-values of 0, 2000, and 3000 s/mm2. Anatomical distortion of prostate (AD), signal intensity of benign prostate (PSI), and lesion conspicuity score (LCS) were assessed using a 4-point scale; and signal-to-noise ratio, contrast-to-noise ratio, and mean ADC (×10–3 mm2/s) of lesion (lADC) and surrounding benign region (bADC) were measured. Results: PSI was significantly lower in uhDWI than in hDWI (p < 0.001). AD, LCS, signal-to-noise ratio, and contrast-to-noise ratio were comparable between uhDWI and hDWI (all p > 0.05). In contrast, lADC was significantly lower than bADC in both uhDWI and hDWI (both p < 0.001). In comparison of lADC between tumors of ≤GG2 and those of ≥GG3, both uhDWI and hDWI showed significant difference (p = 0.007 and p = 0.021, respectively). AUC for separating tumors of ≤GG2 from those of ≥GG3 was 0.731 in hDWI and 0.699 in uhDWI (p = 0.161). Conclusion: uhDWI suppressed background signal better than hDWI, but did not contribute to increased diagnostic performance in PC. Advances in knowledge: Compared with hDWI, uhDWI could not contribute to increased diagnostic performance in PC.

scholarly journals von Willebrand factor as a biomarker of clinically significant portal hypertension and severe portal hypertension: a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e025656
Author(s):  
Ziyuan Zou ◽  
Xinwen Yan ◽  
Cheng Li ◽  
Xiaofeng Li ◽  
Xiaofen Ma ◽  
...  
Keyword(s):  
Systematic Review ◽  
Portal Hypertension ◽  
Correlation Coefficient ◽  
Von Willebrand Factor ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
Moderate Correlation ◽  
Clinically Significant ◽  
Von Willebrand ◽  
Willebrand Factor

ObjectiveThis meta-analysis was performed to investigate the correlation between von Willebrand factor (vWF) antigen and hepatic venous pressure gradient (HVPG) and to evaluate the diagnostic performance of vWF to detect clinically significant portal hypertension (CSPH) and severe portal hypertension (SPH).DesignSystematic review and meta-analysis.MethodsMEDLINE, EMBASE, Web of Science and the Cochrane Library were screened up to 5 April 2018. Studies related to the diagnostic performance of vWF to detect CSPH and/or SPH with HVPG as the reference standard were included. Study quality was assessed by using the Quality Assessment of Diagnostic Accuracy Studies scale. Two authors independently used a standardised form to extract data.OutcomesThe primary outcome was the correlation coefficient between vWF and HVPG. The secondary outcome was the diagnostic performance of vWF to detect CSPH or SPH.ResultsA total of six articles involving 994 patients were included in this study. Five of the included articles were used to stratify the results for the correlation coefficient, three for the diagnostic performance of CSPH and two for SPH. The pooled correlation coefficient based on the random effects model was 0.54 (95% CI 0.35 to 0.69), thus suggesting a moderate correlation between vWF and HVPG. The pooled sensitivity, specificity and area under the curve of vWF for CSPH detection were 82% (95% CI 78 to 86), 76% (95% CI 68 to 83) and 0.87 (95% CI 0.80 to 0.94), respectively. Regarding the ability of vWF to detect SPH, the pooled sensitivity and specificity were 86% (95% CI 80 to 90) and 75% (95% CI 66 to 83), respectively. These results supported the satisfactory diagnostic performance of vWF for CSPH and SPH detection.ConclusionsvWF, as a novel biomarker, has a moderate correlation with HVPG and shows a satisfactory performance for the diagnosis of CSPH and SPH in patients with cirrhosis.

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