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

Abstract

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.

Low PI-RADS assessment category excludes extraprostatic extension (≥pT3a) of prostate cancer: a histology-validated study including 301 operated patients

“…This may limit the applicability of our results for single readers in clinical practice. Reports indicate that inter-reader reproducibility of PI-RADS v2 tends to be moderate and experience dependent [29, 30]. We would therefore expect that expert single readers would have similar performance to that reported in the present study.…”

Interobserver agreement of Prostate Imaging–Reporting and Data System (PI-RADS–v2)

“…One study reported that good interobserver agreement rates use the most appropriate analysis (AC1 = 0.71) and moderate use kappa analysis (kappa = 0.43) [17]. Few studies reported good interobserver agreement using PI-RADS V2 with a remarkable effect on the radiologist's prior experience [19][20][21][22][23][24]. In our work, we found an excellent interobserver agreement using PI-RADS-v2 in reporting MP-MRI for prostate lesions.…”

“…The main target is to build acceptable technical standards for prostate mp-MRI, which makes it clear and simpler with subsequent standardized reporting terms, as well as help the procedure of MRI-guided biopsy. It also develops assessment groups that summarize ranks of the risk that could be helpful to choose and prepare patients for the next steps in management and finally enhance interdisciplinary communications with physicians [6,[9][10][11][12][13][14][15][16][17][18][19]. Having both targeted and systematic biopsy could offer the peak discovery of clinically significant prostate cancer [20][21][22][23][24][25][26][27].…”

“…Numerous MRI-guided sampling procedures will enhance the recognition of clinically significant PCa as well as decrease the discovery of insignificant cancer decreasing the unnecessary costly treatments and their possible complications [27]. Many studies discussed the interobserver agreement of PI-RADS-v2 in the assessment and discovery of prostate cancer [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. The uniqueness of our study is the assessment of interobserver in the peripheral zone (PZ) and the central zone (CZ) separately, as well as the interobserver agreement of the different pulse sequences of PI-RADS-v2.…”

Factors Influencing Variability in the Performance of Multiparametric Magnetic Resonance Imaging in Detecting Clinically Significant Prostate Cancer: A Systematic Literature Review

“…Greer et al [74] reported excellent agreement on index lesion identification (k = 0.87) and moderate agreement on individual PI-RADS v2 category assignment (k = 0.419). Other two welldesigned studies [75,76] reported similar results, with an area under the curve (AUC) for PCa ranging between 0.88 and 0.95 among six blinded readers [75]. Conversely, two recent studies showed high variability in PI-RADS v2 reporting [77,78].…”