Inter-reader agreement of the prostate imaging reporting and data system version v2.1 for detection of prostate cancer: A systematic review and meta-analysis

Abstract

ObjectivesWe aimed to systematically assess the inter-reader agreement of the Prostate Imaging Reporting and Data System Version (PI-RADS) v2.1 for the detection of prostate cancer (PCa).MethodsWe included studies reporting inter-reader agreement of different radiologists that applied PI-RADS v2.1 for the detection of PCa. Quality assessment of the included studies was performed with the Guidelines for Reporting Reliability and Agreement Studies. The summary estimates of the inter-reader agreement were pooled with the random-effect model and categorized (from slight to almost perfect) according to the kappa (κ) value. Multiple subgroup analyses and meta-regression were performed to explore various clinical settings.ResultsA total of 12 studies comprising 2475 patients were included. The pooled inter-reader agreement for whole gland was κ=0.65 (95% CI 0.56-0.73), and for transitional zone (TZ) lesions was κ=0.62 (95% CI 0.51-0.72). There was substantial heterogeneity presented throughout the studies (I2= 95.6%), and meta-regression analyses revealed that only readers’ experience (<5 years vs. ≥5 years) was the significant factor associated with heterogeneity (P<0.01). In studies providing head-to-head comparison, there was no significant difference in inter-reader agreement between PI-RADS v2.1 and v2.0 for both the whole gland (0.64 vs. 0.57, p=0.37), and TZ (0.61 vs. 0.59, p=0.81).ConclusionsPI-RADS v2.1 demonstrated substantial inter-reader agreement among radiologists for whole gland and TZ lesions. However, the difference in agreement between PI-RADS v2.0 and v2.1 was not significant for the whole gland or the TZ.

Evaluating Diagnostic Accuracy and Inter-reader Agreement of the Prostate Imaging After Focal Ablation Scoring System

“…This level of concordance is notable considering that neither had prior clinical experience with PI-FAB prior to taking part in this study. This outcome aligns with more established image reporting systems in the field, such as Prostate Imaging Quality (PI-QUAL) and PI-RADS, where similar levels of inter-reader agreement have been documented, but performance improved with time [23] , [24] , [25] . The agreement observed in our study reflects the inherent challenges in standardizing new diagnostic tools and underscores the potential for improved consistency as PI-FAB is used over time.…”

Biparametric MRI-based radiomics classifiers for the detection of prostate cancer in patients with PSA serum levels of 4∼10 ng/mL

“…PI-RADS hinges on the subjective judgment of radiologists, which is prone to inter-reader variability ( 28 ). A recent meta-analysis ( 29 ) showed varied inter-reader agreements of PI-RADS v2.1 and moderate inter-reader reliability (pooled k value of 0.65) among radiologists for whole gland and TZ lesions. Nonetheless, PI-RAS 2.1 has higher inter-reader reproducibility than version 2.0 ( 30 ).…”

Application of Advanced Imaging to Prostate Cancer Diagnosis and Management: A Narrative Review of Current Practice and Unanswered Questions

“…Another retrospective analysis of men who underwent both DRE and MRI prior to prostatectomy had similar findings, with MRI having higher sensitivity than DRE (59% vs. 41%, p < 0.01) in the detection of extraprostatic disease, but lower specificity (69% vs. 95%, p < 0.01) [12]. Of note, the interobserver variability of DRE in detecting suspicious lesions is greater than that of MRI (k = 0.22 vs. k = 0.57) [13,14].…”