Comparison of PI-RADS 2, ADC histogram-derived parameters, and their combination for the diagnosis of peripheral zone prostate cancer

Lin, Wei-Che; Westphalen, Antonio C.; Silva, G E; Chodraui-Filho, Salomao Faroj; Reis, Rodolfo Borges dos; Muglia, Valdair Francisco

doi:10.1007/s00261-016-0826-4

Cited by 17 publications

(10 citation statements)

References 24 publications

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“…Our results comparing ADC metrics between tumor and normal tissue are similar to those previously reported, with significantly lower mean ADC T than those in healthy-appearing PZ prostate tissue (ADC N ) [11,31,32]. Various ADC metrics have been investigated, including ADC mean and ADC ratio , for detection of csPC.…”

Section: Discussionsupporting

confidence: 87%

“…Various ADC metrics have been investigated, including ADC mean and ADC ratio , for detection of csPC. ADC mean values can either be calculated on a single slice that contains the largest volume of tumor, or on multiple slices to include whole tumor 3D volume [11,31,33]. ADC ratio is defined as the ratio of ADC values of tumor to normal tissue, which aims to minimize the impact of study-specific imaging protocols [11,34].…”

Section: Discussionmentioning

confidence: 99%

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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

et al. 2017

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Purpose To compare diagnostic performance of PI-RADSv2 with ADC parameters to identify clinically significant prostate cancer (csPC) and to determine the impact of csPC definitions on diagnostic performance of ADC and PI-RADSv2. Methods We retrospectively identified treatment-naïve pathology-proven peripheral zone PC patients who underwent 3T prostate MRI, using high b-value diffusion-weighted imaging from 2011–2015. Using 3D slicer, areas of suspected tumor (T) and normal tissue (N) on ADC (b=0,1400) were outlined volumetrically. Mean ADCT, mean ADCN, ADCratio (ADCT/ADCN) were calculated. PI-RADSv2 was assigned. Three csPC definitions were used: (A) Gleason score (GS)≥4+3; (B) GS≥3+4; (C) MRI-based tumor volume>0.5cc. Performances of ADC parameters and PI-RADSv2 in identifying csPC were measured using nonparametric comparison of receiver operating characteristic curves using the area under the curve (AUC). Results 85 cases met eligibility requirements. Diagnostic performances (AUC) in identifying csPC using 3 definitions were: (A) ADCT (0.83) was higher than PI-RADSv2 (0.65, p=0.006); (B) ADCT (0.86) was higher than ADCratio (0.68, p<0.001), and PI-RADSv2 (0.70, p=0.04); (C) PI-RADSv2 (0.73) performed better than ADCratio (0.56, p=0.02). ADCT performance was higher when csPC was defined by A or B versus C (p=0.038 and p=0.01, respectively). ADCratio performed better when csPC was defined by A versus C (p=0.01). PI-RADSv2 performance was not affected by csPC definition. Conclusions When csPC was defined by GS, ADC parameters provided better csPC discrimination than PI-RADSv2, with ADCT providing best result. When csPC was defined by MRI-calculated volume, PI-RADSv2 provided better discrimination than ADCratio. csPC definition did not affect PI-RADSv2 diagnostic performance.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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“…This approach provides more accurate localization and high-quality images for the detection of prostate diseases, especially for PCa. [ 4 5 6 7 ] Due to differences in magnetic resonance scanners, acquisition parameter settings, and subjective evaluation criteria, the interpretation of mp-MRI findings by radiologists differs from different clinicians. Therefore, how to unify diagnostic systems and bridge the gap between different radiologists is increasingly recognized as an important clinical problem.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Performance and Interobserver Consistency of the Prostate Imaging Reporting and Data System Version 2

Zan

Wang

Min

et al. 2018

Chinese Medical Journal

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Background:One of the main aims of the updated Prostate Imaging Reporting and Data System Version 2 (PI-RADS v2) is to diminish variation in the interpretation and reporting of prostate imaging, especially among readers with varied experience levels. This study aimed to retrospectively analyze diagnostic consistency and accuracy for prostate disease among six radiologists with different experience levels from a single center and to evaluate the diagnostic performance of PI-RADS v2 scores in the detection of clinically significant prostate cancer (PCa).Methods:From December 2014 to March 2016, 84 PCa patients and 99 benign prostatic shyperplasia patients who underwent 3.0T multiparametric magnetic resonance imaging before biopsy were included in our study. All patients received evaluation according to the PI-RADS v2 scale (1–5 scores) from six blinded readers (with 6 months and 2, 3, 4, 5, or 17 years of experience, respectively, the last reader was a reviewer/contributor for the PI-RADS v2). The correlation among the readers' scores and the Gleason score (GS) was determined with the Kendall test. Intra-/inter-observer agreement was evaluated using κ statistics, while receiver operating characteristic curve and area under the curve analyses were performed to evaluate the diagnostic performance of the scores.Results:Based on the PI-RADS v2, the median κ score and standard error among all possible pairs of readers were 0.506 and 0.043, respectively; the average correlation between the six readers' scores and the GS was positive, exhibiting weak-to-moderate strength (r = 0.391, P = 0.006). The AUC values of the six radiologists were 0.883, 0.924, 0.927, 0.932, 0.929, and 0.947, respectively.Conclusion:The inter-reader agreement for the PI-RADS v2 among the six readers with different experience is weak to moderate. Different experience levels affect the interpretation of MRI images.

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“…This number is within our category of mildly low ADC values that were associated with at least doubling of the odds of clinically significant prostate cancer. Lin et al, however, did not identify an improvement in the diagnostic performance of PI-RADS v2 with the addition of ADC value measurements (10). It is difficult to explain this discrepancy, which is likely multifactorial.…”

Section: Discussionmentioning

confidence: 99%

Detection of clinically significant prostate cancer with PI-RADS v2 scores, PSA density, and ADC values in regions with and without mpMRI visible lesions

Westphalen

Fazel²,

Nguyen

et al. 2019

Int. braz j urol.

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Purpose To determine if PSAD, PSADtz, and ADC values improve the accuracy of PI-RADS v2 and identify men whose concurrent systematic biopsy detects clinically significant cancer on areas without mpMRI visible lesions.Materials and methodsSingle reference-center, cross-sectional, retrospective study of consecutive men with suspected or known low to intermediate-risk prostate cancer who underwent 3T mpMRI and TRUS-MRI fusion biopsy from 07/15/2014 to 02/17/2018. Cluster-corrected logistic regression analyses were utilized to predict clinically significant prostate cancer (Gleason score ≥3+4) at targeted mpMRI lesions and on systematic biopsy.Results 538 men (median age=66 years, median PSA=7.0ng/mL) with 780mpMRI lesions were included. Clinically significant disease was diagnosed in 371 men. PI-RADS v2 scores of 3, 4, and 5 were clinically significant cancer in 8.0% (16/201), 22.8% (90/395), and 59.2% (109/184). ADC values, PSAD, and PI-RADS v2 scores were independent predictors of clinically significant cancer in targeted lesions (OR 2.25-8.78; P values <0.05; AUROC 0.84, 95% CI 0.81-0.87). Increases in PSAD were also associated with upgrade on systematic biopsy (OR 2.39-2.48; P values <0.05; AUROC 0.69, 95% CI 0.64-0.73).Conclusions ADC values and PSAD improve characterization of PI-RADS v2 score 4 or 5 lesions. Upgraded on systematic biopsy is slightly more likely with PSAD ≥0.15 and multiple small PI-RADS v2 score 3 or 4 lesions.

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Comparison of PI-RADS 2, ADC histogram-derived parameters, and their combination for the diagnosis of peripheral zone prostate cancer

Abstract: DWI PI-RADS V2 score may a better predictor of clinically significant PCa than the overall PI-RADS V2 score, but its diagnostic performance was not significantly improved by the addition of objective ADC value measurements.

Cited by 17 publications

References 24 publications

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

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

Diagnostic Performance and Interobserver Consistency of the Prostate Imaging Reporting and Data System Version 2

Detection of clinically significant prostate cancer with PI-RADS v2 scores, PSA density, and ADC values in regions with and without mpMRI visible lesions

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