Intra‐ and interreader reproducibility of PI‐RADSv2: A multireader study

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Abstract

The Prostate Imaging Reporting and Data System version 2 (PI-RADSv2) has been in use since 2015; while interreader reproducibility has been studied, there has been a paucity of studies investigating the intrareader reproducibility of PI-RADSv2.

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Magnetic resonance imaging/ultrasound fusion guided prostate biopsy improves cancer detection following transrectal ultrasound biopsy and correlates with multiparametric magnetic resonance imaging.

Peter Pinto, Paul Chung, Ardeshir R. Rastinehad … (2011)

A novel platform was developed that fuses pre-biopsy magnetic resonance imaging with real-time transrectal ultrasound imaging to identify and biopsy lesions suspicious for prostate cancer. The cancer detection rates for the first 101 patients are reported. This prospective, single institution study was approved by the institutional review board. Patients underwent 3.0 T multiparametric magnetic resonance imaging with endorectal coil, which included T2-weighted, spectroscopic, dynamic contrast enhanced and diffusion weighted magnetic resonance imaging sequences. Lesions suspicious for cancer were graded according to the number of sequences suspicious for cancer as low (2 or less), moderate (3) and high (4) suspicion. Patients underwent standard 12-core transrectal ultrasound biopsy and magnetic resonance imaging/ultrasound fusion guided biopsy with electromagnetic tracking of magnetic resonance imaging lesions. Chi-square and within cluster resampling analyses were used to correlate suspicion on magnetic resonance imaging and the incidence of cancer detected on biopsy. Mean patient age was 63 years old. Median prostate specific antigen at biopsy was 5.8 ng/ml and 90.1% of patients had a negative digital rectal examination. Of patients with low, moderate and high suspicion on magnetic resonance imaging 27.9%, 66.7% and 89.5% were diagnosed with cancer, respectively (p <0.0001). Magnetic resonance imaging/ultrasound fusion guided biopsy detected more cancer per core than standard 12-core transrectal ultrasound biopsy for all levels of suspicion on magnetic resonance imaging. Prostate cancer localized on magnetic resonance imaging may be targeted using this novel magnetic resonance imaging/ultrasound fusion guided biopsy platform. Further research is needed to determine the role of this platform in cancer detection, active surveillance and focal therapy, and to determine which patients may benefit. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

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Prostate Magnetic Resonance Imaging Interpretation Varies Substantially Across Radiologists

Alan Thong, Richard E Fan, Pejman Ghanouni … (2017)

Multiparametric magnetic resonance imaging (mpMRI) interpreted by experts is a powerful tool for diagnosing prostate cancer. However, the generalizability of published results across radiologists of varying expertise has not been verified.

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What Are We Missing? False-Negative Cancers at Multiparametric MR Imaging of the Prostate

Baris Turkbey, Samuel Borofsky, Arvin George … (2018)

Purpose To characterize clinically important prostate cancers missed at multiparametric (MP) magnetic resonance (MR) imaging. Materials and Methods The local institutional review board approved this HIPAA-compliant retrospective single-center study, which included 100 consecutive patients who had undergone MP MR imaging and subsequent radical prostatectomy. A genitourinary pathologist blinded to MP MR findings outlined prostate cancers on whole-mount pathology slices. Two readers correlated mapped lesions with reports of prospectively read MP MR images. Readers were blinded to histopathology results during prospective reading. At histopathologic examination, 80 clinically unimportant lesions (<5 mm; Gleason score, 3+3) were excluded. The same two readers, who were not blinded to histopathologic findings, retrospectively reviewed cancers missed at MP MR imaging and assigned a Prostate Imaging Reporting and Data System (PI-RADS) version 2 score to better understand false-negative lesion characteristics. Descriptive statistics were used to define patient characteristics, including age, prostate-specific antigen (PSA) level, PSA density, race, digital rectal examination results, and biopsy results before MR imaging. Student t test was used to determine any demographic differences between patients with false-negative MP MR imaging findings and those with correct prospective identification of all lesions. Results Of the 162 lesions, 136 (84%) were correctly identified with MP MR imaging. Size of eight lesions was underestimated. Among the 26 (16%) lesions missed at MP MR imaging, Gleason score was 3+4 in 17 (65%), 4+3 in one (4%), 4+4 in seven (27%), and 4+5 in one (4%). Retrospective PI-RADS version 2 scores were assigned (PI-RADS 1, n = 8; PI-RADS 2, n = 7; PI-RADS 3, n = 6; and PI-RADS 4, n = 5). On a per-patient basis, MP MR imaging depicted clinically important prostate cancer in 99 of 100 patients. At least one clinically important tumor was missed in 26 (26%) patients, and lesion size was underestimated in eight (8%). Conclusion Clinically important lesions can be missed or their size can be underestimated at MP MR imaging. Of missed lesions, 58% were not seen or were characterized as benign findings at second-look analysis. Recognition of the limitations of MP MR imaging is important, and new approaches to reduce this false-negative rate are needed. © RSNA, 2017 Online supplemental material is available for this article.

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Author and article information

Journal

Title: Journal of Magnetic Resonance Imaging

Abbreviated Title: J. Magn. Reson. Imaging

Publisher: Wiley

ISSN (Print): 1053-1807

ISSN (Electronic): 1522-2586

Publication date Created: September 19 2018

Publication date Created: June 2019

Publication date (Electronic): December 21 2018

Publication date (Print): June 2019

Volume: 49

Issue: 6

Pages: 1694-1703

Affiliations

[1 ]Molecular Imaging Program, National Cancer Institute, NIH Bethesda Maryland USA

[2 ]Georgetown University School of Medicine Washington D.C. USA

[3 ]Clinical Monitoring Research DirectorateFrederick National Laboratory for Cancer Research sponsored by the National Cancer Institute Frederick MD USA

[4 ]Department of RadiologyAddenbrooke's Hospital and the University of Cambridge Cambridge UK

[5 ]Department of RadiologyFluminese Federal University Rio de Janeiro Brazil

[6 ]CDPI Clinics, DASA Rio de Janeiro Brazil

[7 ]Department of Diagnostic RadiologySingapore General Hospital Singapore

[8 ]Department of Radiology, Urology CenterMansoura University Mansoura City Egypt

[9 ]Northeast Ohio Medical University Rootstown Ohio USA

[10 ]Urologic Oncology BranchNational Cancer Institute, NIH Bethesda Maryland USA

[11 ]Department of Urology and Pediatric UrologyUniversity Medical Center Mainz Germany

[12 ]Department of Radiology, Dr. Behcet Uz Child Disease and Pediatric Surgery Training and Research HospitalUniversity of Health Sciences Ýzmir Turkey

[13 ]Department of Interventional OncologyNational Cancer Institute, NIH Bethesda Maryland USA

[14 ]Biometric Research Program, National Cancer Institute, NIH Rockville Maryland USA

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DOI: 10.1002/jmri.26555

PMC ID: 6504619

PubMed ID: 30575184

SO-VID: 0e38adbb-11bb-4528-a30a-616b564bc72f

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Intra‐ and interreader reproducibility of PI‐RADSv2: A multireader study

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Most cited references 15

Magnetic resonance imaging/ultrasound fusion guided prostate biopsy improves cancer detection following transrectal ultrasound biopsy and correlates with multiparametric magnetic resonance imaging.

Prostate Magnetic Resonance Imaging Interpretation Varies Substantially Across Radiologists

What Are We Missing? False-Negative Cancers at Multiparametric MR Imaging of the Prostate

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