Imaging Facilities' Adherence to PI-RADS v2 Minimum Technical Standards for the Performance of Prostate MRI

Esses, Steven J.; Taneja, Samir S.; Rosenkrantz, Andrew B.

doi:10.1016/j.acra.2017.08.013

Cited by 65 publications

(31 citation statements)

References 15 publications

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“…If slightly different criteria suggested by other authors were applied to our cohort (i.e., PIRADS = 3 and PSAD < 0.15) [14,16,17], it would result in a 50% reduction in the number of biopsies but would also miss 21% of significant cancers. We speculate that the discrepancy between this finding and those reported in other papers might be explained by the performance of the mpMRI [3,18,19]. This study has some limitations.…”

Section: Discussioncontrasting

confidence: 70%

Use of Prostate Specific Antigen Density Combined with Multiparametric Magnetic Resonance Imaging Improves Triage for Prostate Biopsy

et al. 2019

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Background: Multi-parametric magnetic resonance imaging (mpMRI)-directed biopsy for prostate cancer (PC) diagnosis improves the detection of clinically significant prostate cancer (CSPC) and decreases the rate of over-diagnosis of insignificant disease. The aim of this study was to investigate the value of mpMRI combined with prostate specific antigen density (PSAD) in the decision making related to the biopsy. Methods: mpMRI and mpMRI/transrectal ultrasound fusion targeted biopsies with subsequent systematic biopsies were performed in 397 patients (223 biopsy-naïve and 174 with a previous biopsy). Detection rates of (CSPC) and insignificant PC were stratified using the PIRADS score, and the number of avoidable biopsies and missed (CSPC) were plotted against PSAD values of 0.1–0.5 ng/mL². Results: PIRADS <3 and PSAD <0.2 ng/mL² were the safest criteria for not performing a biopsy. When applied to the biopsy-naïve group, 21.5% (48/223) of the biopsies could have been avoided and 3.7% (3/82) of CSPC would have been missed. In the repeat biopsy group, 12.6% (22/174) of biopsies could have been avoided and 6.9% (4/58) of (CSPC) would have been missed. Conclusions: A combination of mpMRI and PSAD might reduce the number of biopsies performed with the cost of missing <4% of CSPC.

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Section: Discussioncontrasting

confidence: 70%

Use of Prostate Specific Antigen Density Combined with Multiparametric Magnetic Resonance Imaging Improves Triage for Prostate Biopsy

et al. 2019

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“…These issues are not helped by the wide variability in technique that has been observed in surveys of practices performing mpMRI. Esses et al conducted a survey that revealed a highly variable level of adherence to PI-RADSv2 technical standards across imaging facilities, suggesting that image quality may often be compromised [ 33 ]. This problem can only be overcome by better training and education.…”

Section: Discussionmentioning

confidence: 99%

Can computer-aided diagnosis assist in the identification of prostate cancer on prostate MRI? a multi-center, multi-reader investigation

et al. 2018

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For prostate cancer detection on prostate multiparametric MRI (mpMRI), the Prostate Imaging-Reporting and Data System version 2 (PI-RADSv2) and computer-aided diagnosis (CAD) systems aim to widely improve standardization across radiologists and centers. Our goal was to evaluate CAD assistance in prostate cancer detection compared with conventional mpMRI interpretation in a diverse dataset acquired from five institutions tested by nine readers of varying experience levels, in total representing 14 globally spread institutions.Index lesion sensitivities of mpMRI-alone were 79% (whole prostate (WP)), 84% (peripheral zone (PZ)), 71% (transition zone (TZ)), similar to CAD at 76% (WP, p=0.39), 77% (PZ, p=0.07), 79% (TZ, p=0.15). Greatest CAD benefit was in TZ for moderately-experienced readers at PI-RADSv2 <3 (84% vs mpMRI-alone 67%, p=0.055). Detection agreement was unchanged but CAD-assisted read times improved (4.6 vs 3.4 minutes, p<0.001). At PI-RADSv2 ≥ 3, CAD improved patient-level specificity (72%) compared to mpMRI-alone (45%, p<0.001).PI-RADSv2 and CAD-assisted mpMRI interpretations have similar sensitivities across multiple sites and readers while CAD has potential to improve specificity and moderately-experienced radiologists’ detection of more difficult tumors in the center of the gland. The multi-institutional evidence provided is essential to future prostate MRI and CAD development.

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“…This approach also decreases the detection of insignificant disease [28,31] and improves risk stratification for diagnosed patients [32]. There are challenges in implementing prostate mpMRI-MRDB in clinical practice, including heterogeneity of image quality between centers [33] and consequently variations in the diagnostic performance for PCa detection [34]. Specifically, prostate mpMRI quality depends on MRI equipment capabilities (including equipment vendor, magnet field and gradient strength, coil set used, software and hardware levels, sequence parameter choices), patient factors (medications, body habitus, motion, metal implants, rectal gas), biopsy-related prostate gland hemorrhage, and most importantly the radiologic interpretation of images (learning curve effects, subjectivity of observations, interobserver variations, and reporting styles).…”

Section: Prostate Mpmrimentioning

confidence: 99%

Prostate Imaging-Reporting and Data System Steering Committee: PI-RADS v2 Status Update and Future Directions

et al. 2019

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Multiparametric magnetic resonance imaging (MRI) and MRI-directed biopsies using the Prostate Imaging-Reporting and Data System improves the detection of prostate cancers likely to cause harm, and at the same time decreases the detection of disease that does not lead to harms if left untreated. The keys to success are high-quality imaging, reporting, and biopsies by radiologists and urologists working together in multidisciplinary teams.

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Imaging Facilities' Adherence to PI-RADS v2 Minimum Technical Standards for the Performance of Prostate MRI

Cited by 65 publications

References 15 publications

Use of Prostate Specific Antigen Density Combined with Multiparametric Magnetic Resonance Imaging Improves Triage for Prostate Biopsy

Use of Prostate Specific Antigen Density Combined with Multiparametric Magnetic Resonance Imaging Improves Triage for Prostate Biopsy

Can computer-aided diagnosis assist in the identification of prostate cancer on prostate MRI? a multi-center, multi-reader investigation

Prostate Imaging-Reporting and Data System Steering Committee: PI-RADS v2 Status Update and Future Directions

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