Bladder cancer tends to show peak enhancement with the 60-second scanning delay. Multi-detector row helical CT is useful in the detection and staging of bladder cancer.

Background: There are no standardized and well-validated criteria for assessing the risk of extraprostatic extension (EPE) of prostate cancer at preoperative multiparametric MRI.Purpose: To compare diagnostic performance, intra-and interreader agreement, and correlations of MRI-based criteria for assessment of EPE after radical prostatectomy, including EPE grade, European Society of Urogenital Radiology (ESUR) score, Likert scale, and capsular contact length (CCL). Materials and Methods:This retrospective study included consecutive men who underwent MRI and radical prostatectomy between July 2016 and March 2017. Two genitourinary radiologists independently estimated the probability of EPE by using four MRIbased scoring methods. The diagnostic accuracies and intra-and interobserver agreement were evaluated with area under the receiver operating characteristic curve (AUC) and k statistics, respectively. Correlations between MRI-based score and histologic extent of EPE were analyzed by using the Spearman correlation coefficient (r).Results: A total of 301 men (mean age 6 standard deviation, 65 years 6 7) were evaluated. A total of 129 (42.9%) men had EPE. The AUC ranges of EPE grade, ESUR score, Likert scale, and CCL for assessment of EPE were 0.77-0.81, 0.79-0.81, 0.78-0.79, and 0.78-0.85, respectively, for the two readers. The Likert scale showed lower sensitivity (68.2% [88 of 129] for reader 1, 72.1% [93 of 129] for reader 2) than did EPE grade (77.5% [100 of 129] for reader 1, 79.8% [103 of 129] for reader 2; P  .04). Intraand interreader agreement were substantial (k range, 0.61-0.74) for the four methods, with ESUR score showing the lowest values (k = 0.61 and k = 0.63, respectively). EPE grade showed highest correlation with histologic extent of EPE (r = 0.53 and r = 0.55 for circumferential length; r = 0.42 and r = 0.55 for radial length for readers 1 and 2, respectively; P , .001). Conclusion:Extraprostatic extension (EPE) grade, European Society of Urogenital Radiology score, Likert scale, and capsular contact length showed good overall diagnostic performance; however, the EPE grade resulted in more reliable performance and had the highest correlation with histologic EPE extent.

Background: The Prostate Imaging Reporting and Data System (PI-RADS) was introduced in 2012 and updated to version 2.1 (v2.1) in early 2019 to improve diagnostic performance and interreader reliability. Purpose: To evaluate the diagnostic performance of PI-RADS v2.1 in comparison with v2. Methods: A systematic review and meta-analysis of the literature was performed using MEDLINE, EMBASE, and Cochrane databases to identify studies evaluating the diagnostic performance of PI-RADS v2.1 for diagnosing clinically significant prostate cancer (csPCa). Study Type: Systematic review and meta-analysis. Subject: One thousand two hundred forty-eight patients with 1406 lesions from 10 eligible articles. Field Strength/sequence: Conventional MR sequences at 1.5 T and 3 T. Assessment: Two reviewers independently identified and reviewed the original articles reporting diagnostic performance of PI-RADS v2.1. Statistical Tests: Meta-analytic summary sensitivity and specificity were calculated using a bivariate random effects model. Meta-analytic sensitivity and specificity between PI-RADS v2 and v2.1 were compared. Results: The pooled sensitivity and specificity of PI-RADS v2.1 were 87% (95% confidence intervals, 82-91%) and 74% (63-82%), respectively. In five studies available for a head-to-head comparison between PI-RADS v2.1 and v2, there were no significant differences in either sensitivity (90% [86-94%] vs. 88% [83-93%], respectively) or specificity (76% [59-93%] vs. 61% [39-83%], respectively; P = 0.37). The sensitivity and specificity were 81% (73-87%) and 82% (68-91%), respectively, for a PI-RADS score cutoff of ≥4, and 94% (88-97%) and 56% (35-97%) for ≥3. Regarding the zonal location, the sensitivity and specificity for the transitional zone only were 90% (84-96%) and 76% (62-90%) respectively, whereas for the whole gland they were 85% (79-91%) and 71% (57-85%). Data Conclusion: PI-RADS v2.1 demonstrated good overall performance for the diagnosis of csPCa. PI-RADS v2.1 tended to show higher specificity than v2, but the difference lacked statistical significance. Level of Evidence: 3 Technical Efficacy Stage: 3

No abstract

The DWI method, ADC calculation method, and selection of b-values potentially influence the ADCs and the reproducibility of malignant hepatic tumors. ADCs calculated from breath-hold DWI are more reproducible than from respiratory-triggered DWI. A multiple b-value method may improve the reproducibility of respiratory-triggered DWI.

2 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:813-819.

Purpose: We evaluated interreader agreement with PI-RADSÒ (Prostate Imaging Reporting and Data System) version 2 for detection of prostate cancer. Materials and Methods: We searched MEDLINEÒ, EmbaseÒ and the Cochrane Library between 2015 and June 3, 2019 to identify original research reporting interreader agreement in the use of PI-RADS version 2. Quality of the retrieved studies was assessed by 2 independent reviewers using the Guidelines for Reporting Reliability and Agreement Studies. Pooled k for PI-RADS version 2 was calculated, and a head-to-head comparison with version 1 was performed for the available studies. Subgroup analysis was performed according to zonal anatomy (peripheral or transitional zone), cutoff value (4 or higher, or 3 or higher) and specific imaging sequences (T2-weighted, diffusion-weighted and dynamic contrast enhanced). Meta-regression analysis was performed to assess the cause of study heterogeneity. Results: A total of 30 studies (4,095 patients) were included. Pooled k of PI-RADS version 2 was 0.61 (95% CI 0.55e0.67). In 4 studies evaluating head-to-head comparisons PI-RADS versions 1 and 2 showed similar pooled k values (0.61, 95% CI 0.33e0.90 vs 0.68, 95% CI 0.57e0.79; p[0.61). Substantial interreader agreement was noted with a cutoff of 4 or higher (k[0.61) and moderate agreement was observed with a cutoff of 3 or higher (k[0.57), peripheral zone (k[0.64), transitional zone (k[0.49) and the 3 magnetic resonance imaging sequences (k 0.42e0.58). Difference in reader experience was the single significant factor affecting study heterogeneity (p[0.01). Conclusions: PI-RADS version 2 provides substantial interreader agreement in overall scoring in patients with suspicious prostate cancer, with a similar level of agreement to version 1.

Familiarity with the clinical setting and imaging features of benign solid testicular and paratesticular lesions should facilitate prompt, accurate diagnosis and treatment.