Evaluation of the PI-RADS Scoring System for Classifying mpMRI Findings in Men with Suspicion of Prostate Cancer

Junker, Daniel; Schäfer, Georg; Edlinger, Michael; Kremser, Christian; Bektic, Jasmin; Horninger, Wolfgang; Jaschke, Werner; Aigner, Friedrich

doi:10.1155/2013/252939

Cited by 51 publications

(34 citation statements)

References 24 publications

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“…In our study, there were no significant differences in the When stratifying results according to location of targets, we and others who report on MR-guided targeted biopsy report a higher percentage of targets in the transition zone than in the peripheral zone (16). Of the published studies on MR-guided targeted biopsy, 44% of MR-US fusion procedures (17) and 47% of in-bore biopsies of the lesions were in the peripheral zone (10). Reported rates are consistent with our rate of 41.1% of the target lesions in the peripheral zone.…”

Section: Genitourinary Imaging: In-bore 3-t Mr-guided Transrectal Tarcontrasting

confidence: 53%

In-Bore 3-T MR-guided Transrectal Targeted Prostate Biopsy: Prostate Imaging Reporting and Data System Version 2–based Diagnostic Performance for Detection of Prostate Cancer

et al. 2017

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Section: Genitourinary Imaging: In-bore 3-t Mr-guided Transrectal Tarcontrasting

confidence: 53%

In-Bore 3-T MR-guided Transrectal Targeted Prostate Biopsy: Prostate Imaging Reporting and Data System Version 2–based Diagnostic Performance for Detection of Prostate Cancer

et al. 2017

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“…For all sequences combined, Portalez et al (25) showed an area under the ROC curve of 0.86 for the PI-RADS in 129 patients who were referred for repeat biopsies with fusionguided biopsy as the reference standard. Junker et al (4) found an area under the ROC curve of 0.97 for all sequences combined in the PZ in 50 patients, with whole-mount prostatectomy as a reference standard. In the TZ, however, probability of cancer and PI-RADS score in the PZ (score of 2, 0.17; score of 3, 0.2; score of 4, 0.67; and score of 5, 0.95) and in the TZ (score of 2, 0.13; score of 3, 0.15; score of 4, 0.6; and score of 5, 0.93).…”

Section: Discussionmentioning

confidence: 99%

“…For instance, Baur et al (3) reported that assigning a PI-RADS score on the basis of DWI for PZ lesions and a PI-RADS score on the basis of T2-weighted imaging for TZ lesions was sufficient for stratification of patients for further diagnostic workup. Furthermore, the contribution of DCE MR imaging curve-type analysis was reported to be of questionable value (3,4).…”

Section: Study Design and Patient Populationmentioning

confidence: 99%

Prostate Cancer: Interobserver Agreement and Accuracy with the Revised Prostate Imaging Reporting and Data System at Multiparametric MR Imaging

Muller¹,

Shih²,

Sankineni³

et al. 2015

Radiology

304

198

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).q RSNA, 2015 Purpose:To evaluate accuracy and interobserver variability with the use of the Prostate Imaging Reporting and Data System (PI-RADS) version 2.0 for detection of prostate cancer at multiparametric magnetic resonance (MR) imaging in a biopsy-naïve patient population. Materials and Methods:This retrospective HIPAA-compliant study was approved by the local ethics committee, and written informed consent was obtained from all patients for use of their imaging and histopathologic data in future research studies. In 101 biopsy-naïve patients with elevated prostate-specific antigen levels who underwent multiparametric MR imaging of the prostate and subsequent transrectal ultrasonography (US)-MR imaging fusion-guided biopsy, suspicious lesions detected at multiparametric MR imaging were scored by five readers who were blinded to pathologic results by using to the newly revised PI-RADS and the scoring system developed in-house. Interobserver agreement was evaluated by using k statistics, and the correlation of pathologic results with each of the two scoring systems was evaluated by using the Kendall t correlation coefficient. Results:Specimens of 162 lesions in 94 patients were sampled by means of transrectal US-MR imaging fusion biopsy. Results for 87 (54%) lesions were positive for prostate cancer.Kendall t values with the PI-RADS and the in-house-developed scoring system, respectively, at T2-weighted MR imaging in the peripheral zone were 0.51 and 0.17 and in the transitional zone, 0.45 and 20.11; at diffusion-weighted MR imaging, 0.42 and 0.28; at dynamic contrast materialenhanced MR imaging, 0.23 and 0.24, and overall suspicion scores were 0.42 and 0.49. Median k scores among all possible pairs of readers for PI-RADS and the in-house-developed scoring system, respectively, for T2-weighted MR images in the peripheral zone were 0.47 and 0.15; transitional zone, 0.37 and 0.07; diffusion-weighted MR imaging, 0.41 and 0.57; dynamic contrast-enhanced MR imaging, 0.48 and 0.41; and overall suspicion scores, 0.46 and 0.55. Conclusion:Use of the revised PI-RADS provides moderately reproducible MR imaging scores for detection of clinically relevant disease.q RSNA, 2015

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“…Although PIRADS is increasingly being adopted as a way of communicating mpMRI prostate results, its limitations are well recognized [4]. Most radiologists employ a modified PIRADS scoring technique when reporting mpMRI of the prostate whereby each lesion is not formally scored as per the PIRADS system.…”

Section: Discussionmentioning

confidence: 99%

mp-MRI Prostate Characterised PIRADS 3 Lesions are Associated with a Low Risk of Clinically Significant Prostate Cancer - A Retrospective Review of 92 Biopsied PIRADS 3 Lesions

2015

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Objective: To determine whether prostate image reporting and data system (PIRADS) 3 lesions as assessed by a 3T multiparametric magnetic resonance imaging (MRI) represent clinically significant prostate cancer. Method: A retrospective review was performed on a series of consecutive patients who underwent MRI guided biopsy of the prostate for clinical suspicion of prostate cancer between January 2013 and March 2014. Demographic, clinical, MRI and biopsy data were reviewed and compared. The same 3T MRI without the use of an endo-rectal coil was employed to assess each patient, obtaining high resolution T2 weighted images, diffusion weighted imaging and dynamic contrast enhancement. The MRI data was sent to Dynacad software for analysis. A single experienced radiologist reported all the studies from this series using a modified PIRADS scoring system. Subsequently, all the lesions marked PIRADS 3 or above were targeted with 18G core biopsy using DynaTrim in-gantry MRI guidance system. Needle position targeting the lesion was recorded prior to each biopsy. All core biopsy samples were sent to one of two pathology laboratories where they were processed and reported as per the International Society of Urological Pathology protocols. Results: One hundred and eighteen patients comprising a total of 215 lesions were reviewed. Amongst this cohort, 92 PIRADS 3 lesions were identified and biopsied. The mean age of patients in this cohort was 62.6 years. Median prostate specific antigen (PSA) was 6.5 ng/ml and median prostate size was 78.4 ml. Eightysix (93.5%) of biopsied PIRADS 3 lesions were benign and 6 (6.5%) lesions were found to be malignant. Of these 6 malignant lesions, 4 (66%) were Gleason score 6 (3 + 3) and 2 (33%) were Gleason score 7 (3 + 4). Of the 86 non-malignant lesions, 1 (1.2%) represented high-grade prostate intraepithelial neoplasia and 2 (2.4%) represented atypical small acinar proliferation. PIRADS 3 lesions within the peripheral zone were more likely to be associated with malignant disease compared with lesions identified within the transition zone (10.8 vs. 3.8%). Those with malignant disease had a higher median PSA (8.1 vs. 6.4 ng/ml) and higher median PSA density (0.12 vs. 0.08) than those without malignant disease. Those with benign pathology had a higher prevalence of inflammation (31.4 vs. 16.7%). As per Epstein's criteria, 4 (4.3%) of the biopsied lesions represented clinically significant disease. Conclusion: We have demonstrated in our series, that prostate lesions characterized on a 3T multiparametric MRI examination of the prostate as PIRADS 3, according to the current prevalent scoring systems, are associated with a low likelihood of the presence of clinically significant prostate cancer.

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Evaluation of the PI-RADS Scoring System for Classifying mpMRI Findings in Men with Suspicion of Prostate Cancer

Cited by 51 publications

References 24 publications

In-Bore 3-T MR-guided Transrectal Targeted Prostate Biopsy: Prostate Imaging Reporting and Data System Version 2–based Diagnostic Performance for Detection of Prostate Cancer

In-Bore 3-T MR-guided Transrectal Targeted Prostate Biopsy: Prostate Imaging Reporting and Data System Version 2–based Diagnostic Performance for Detection of Prostate Cancer

Prostate Cancer: Interobserver Agreement and Accuracy with the Revised Prostate Imaging Reporting and Data System at Multiparametric MR Imaging

mp-MRI Prostate Characterised PIRADS 3 Lesions are Associated with a Low Risk of Clinically Significant Prostate Cancer - A Retrospective Review of 92 Biopsied PIRADS 3 Lesions

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