Interreader variability in prostate MRI reporting using Prostate Imaging Reporting and Data System version 2.1

Brembilla, Giorgio; Dell’Oglio, Paolo; Stabile, Armando; Damascelli, Anna; Brunetti, Lisa; Ravelli, Silvia; Cristel, Giulia; Schiani, Elena; Venturini, Elena; Grippaldi, Daniele; Mendola, Vincenzo; Rancoita, Paola Maria Vittoria; Esposito, Antonio; Briganti, Alberto; Montorsi, Francesco; Maschio, Alessandro Del; Cobelli, Francesco De

doi:10.1007/s00330-019-06654-2

Cited by 61 publications

(43 citation statements)

References 28 publications

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“…Brembilla et al also demonstrated overall good reliability of mpMRI interpretation between appropriately trained radiologists of different expertise using PI-RADS v2.1. 21 However, in our study the interreader reliability was lower for PZ lesions for both bpMRI and mpMRI than for TZ lesions. A study of TZ lesions reported that PI-RADS v2.1 reported better interreader reliability than PI-RADS v2.…”

Section: Discussioncontrasting

confidence: 75%

“…For interreader reliability of all lesions (PZ and TZ) using PI‐RADS v2.1, good agreement was demonstrated in both bpMRI and mpMRI. Brembilla et al also demonstrated overall good reliability of mpMRI interpretation between appropriately trained radiologists of different expertise using PI‐RADS v2.1 21 . However, in our study the interreader reliability was lower for PZ lesions for both bpMRI and mpMRI than for TZ lesions.…”

Section: Discussioncontrasting

confidence: 44%

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Comparison of Biparametric and Multiparametric MRI for Clinically Significant Prostate Cancer Detection With PI‐RADS Version 2.1

Tamada

Kido

Yamamoto

et al. 2020

Magnetic Resonance Imaging

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Background: Biparametric MRI (bpMRI) without dynamic contrast-enhanced MRI (DCE-MRI) results in an elimination of adverse events, shortened examination time, and reduced costs, compared to multiparametric MRI (mpMRI). The ability of bpMRI to detect clinically significant prostate cancer (csPC) with the Prostate Imaging and Reporting Data System version 2.1 (PI-RADS v2.1) compared to standard mpMRI has not been studied extensively. Purpose: To compare the interobserver reliability and diagnostic performance for detecting csPC of bpMRI and mpMRI using PI-RADS v2.1. Study Type: Retrospective. Population: In all, 103 patients with elevated prostate-specific antigen (PSA) levels who underwent mpMRI and subsequent MRI-ultrasonography fusion-guided prostate-targeted biopsy (MRGB) with or without prostatectomy. Field Strength/Sequences: T 2-weighted imaging (T 2 WI), diffusion-weighted imaging (DWI), and DCE-MRI at 3T. Assessment: Three readers independently assessed each suspected PC lesion, assigning a score of 1-5 for T 2 WI, a score of 1-5 for DWI, and positive and negative for DCE-MRI according to PI-RADS v2.1 and determined the overall PI-RADS assessment category of bpMRI (T 2 WI and DWI) and mpMRI (T 2 WI, DWI, and DCE-MRI). The reference standard was MRGB or prostatectomy-derived histopathology. Statistical Testing: Statistical analysis was performed using the kappa statistic and McNemar and Delong tests. Results: Of the 165 suspected PC lesions in 103 patients, 81 were diagnosed with csPC and 84 with benign conditions. Interobserver variability of PI-RADS assessment category showed good agreement for bpMRI (kappa value = 0.642) and mpMRI (kappa value = 0.644). For three readers, the diagnostic sensitivity was significantly higher for mpMRI than for bpMRI (P < 0.001 to P = 0.016, respectively), whereas diagnostic specificity was significantly higher for bpMRI than for mpMRI (P < 0.001 each). For three readers, the area under the receiver operating characteristic curve (AUC) was higher for bpMRI than for mpMRI; however, the difference was significant only for Reader 1 and Reader 3 (Reader 1: 0.823 vs. 0.785, P = 0.035; Reader 2: 0.852 vs. 0.829, P = 0.099; and Reader 3: 0.828 vs. 0.773, P = 0.002). Data Conclusion: For detecting csPC using PI-RADS v2.1, the interobserver reliability and diagnostic performance of bpMRI was comparable with those of mpMRI. Level of Evidence: 4 Technical Efficacy Stage: 2

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Section: Discussioncontrasting

confidence: 75%

Section: Discussioncontrasting

confidence: 44%

Comparison of Biparametric and Multiparametric MRI for Clinically Significant Prostate Cancer Detection With PI‐RADS Version 2.1

Tamada

Kido

Yamamoto

et al. 2020

Magnetic Resonance Imaging

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“…It was previously shown to be moderate for PI-RADS v2.0 5,24 . At the time of publication only two studies have addressed interobserver agreement of v2.1 finding a substantial agreement 22,25 . Lastly, although this analysis is based on a large patient cohort, subgroup analysis is underrepresented.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic performance of PI-RADS version 2.1 compared to version 2.0 for detection of peripheral and transition zone prostate cancer

Rudolph

Baur

Cash

et al. 2020

Sci Rep

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The purpose of this study is to compare diagnostic performance of Prostate Imaging Reporting and Data System (PI-RADS) version (v) 2.1 and 2.0 for detection of Gleason Score (GS) ≥ 7 prostate cancer on MRI. Three experienced radiologists provided PI-RADS v2.0 scores and at least 12 months later v2.1 scores on lesions in 333 prostate MRI examinations acquired between 2012 and 2015. Diagnostic performance was assessed retrospectively by using MRI/transrectal ultrasound fusion biopsy and 10-core systematic biopsy as the reference. From a total of 359 lesions, GS ≥ 7 tumor was present in 135 lesions (37.60%). Area under the ROC curve (AUC) revealed slightly lower values for peripheral zone (PZ) and transition zone (TZ) scoring in v2.1, but these differences did not reach statistical significance. A significant number of score 2 lesions in the TZ were downgraded to score 1 in v2.1 showing 0% GS ≥ 7 tumor (0/11). The newly introduced diffusion-weighted imaging (DWI) upgrading rule in v2.1 was applied in 6 lesions from a total of 143 TZ lesions (4.2%). In summary, PI-RADS v2.1 showed no statistically significant differences in overall diagnostic performance of TZ and PZ scoring compared to v2.0. Downgraded BPH nodules showed favorable cancer frequencies. The new DWI upgrading rule for TZ lesions was applied in only few cases.

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“…It is used to classify visible lesions on MRI into categories based on their likelihood of harboring PCA and has been proven to be a good predictor of PCA being present [12]. Many smaller studies [13][14][15][16] and a recent systematic review including 77 studies [17] have reported varying levels of inter-reader agreement, ranging from low to almost perfect, using different versions of the PI-RADS criteria. This suggests a considerable variation in reporting of prostate MRI.…”

Section: Discussionmentioning

confidence: 99%

Visibility of significant prostate cancer on multiparametric magnetic resonance imaging (MRI)—do we still need contrast media?

et al. 2020

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Objectives To assess the visibility of clinically significant prostate cancer (PCA) lesions on the sequences multiparametric MRI of the prostate (mpMRI) and to evaluate whether the addition of dynamic contrast–enhanced imaging (DCE) improves the overall visibility. Methods We retrospectively evaluated multiparametric MRI images of 119 lesions in 111 patients with biopsy-proven clinically significant PCA. Three readers assigned visual grading scores for visibility on each sequence, and a visual grading characteristic analysis was performed. Linear regression was used to explore which factors contributed to visibility in individual sequences. Results The visibility of lesions was significantly better with mpMRI when compared to biparametric MRI in visual grading characteristic (VGC) analysis, with an AUCVGC of 0.62 (95% CI 0.55–0.69; p < 0.001). This benefit was seen across all readers. Multivariable linear regression revealed that a location in the peripheral zone was associated with better visibility on T2-weighted imaging (T2w). A higher Prostate Imaging-Reporting and Data System (PI-RADS) score was associated with better visibility on both diffusion-weighted imaging (DWI) and DCE. Increased lesion size was associated with better visibility on all sequences. Conclusions Visibility of clinically significant PCA is improved by using mpMRI. DCE and DWI images independently improve lesion visibility compared to T2w images alone. Further research into the potential of DCE to impact on clinical decision-making is suggested. Key Points • DCE and DWI images independently improve clinically significant prostate cancer lesion visibility compared to T2w images alone. • Multiparametric MRI (DCE, DWI, T2w) achieved significantly higher visibility scores than biparametric MRI (DWI, T2w). • Location in the transition zone is associated with poor visibility on T2w, while it did not affect visibility on DWI or DCE.

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Interreader variability in prostate MRI reporting using Prostate Imaging Reporting and Data System version 2.1

Cited by 61 publications

References 28 publications

Comparison of Biparametric and Multiparametric MRI for Clinically Significant Prostate Cancer Detection With PI‐RADS Version 2.1

Comparison of Biparametric and Multiparametric MRI for Clinically Significant Prostate Cancer Detection With PI‐RADS Version 2.1

Diagnostic performance of PI-RADS version 2.1 compared to version 2.0 for detection of peripheral and transition zone prostate cancer

Visibility of significant prostate cancer on multiparametric magnetic resonance imaging (MRI)—do we still need contrast media?

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