Standardized Reporting of Prostate MRI: Comparison of the Prostate Imaging Reporting and Data System (PI-RADS) Version 1 and Version 2

Tewes, Susanne; Mokov, Nikolaj; Hartung, Dagmar; Schick, Volker; Peters, Inga; Schedl, Peter; Pertschy, Stefanie; Wacker, Frank; Voshage, Götz; Hueper, Katja

doi:10.1371/journal.pone.0162879

Cited by 44 publications

(29 citation statements)

References 31 publications

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“…In a study with cognitively targeted MR-guided biopsy as the reference standard, Feng et al (20) determined the sensitivity and specificity of PCa in the TZ to be 96% and 90%, respectively, with a cutoff score of 4. In a similar study with MR imaging-guided in-bore biopsy as the reference standard, Tewes et al (21) showed that with PI-RADS version 2, the best diagnostic accuracy in the TZ was reached with a cutoff score of 4 at a sensitivity of 80% and a specificity 100% for all PCa. Polanec et al (22) evaluated PI-RADS version 2 scoring by two readers in a patient population that underwent MR imaging-guided prostate biopsy.…”

Section: Discussionmentioning

confidence: 96%

Validation of PI-RADS Version 2 in Transition Zone Lesions for the Detection of Prostate Cancer

Thai¹,

Narayanan

George

et al. 2018

Radiology

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Purpose To determine the association between Prostate Imaging Reporting and Data System (PI-RADS) version 2 scores and prostate cancer (PCa) in a cohort of patients undergoing biopsy of transition zone (TZ) lesions. Materials and Methods A total of 634 TZ lesions in 457 patients were identified from a prospectively maintained database of consecutive patients undergoing prostate magnetic resonance imaging. Prostate lesions were retrospectively categorized with the PI-RADS version 2 system by two readers in consensus who were blinded to histopathologic findings. The proportion of cancer detection for all PCa and for clinically important PCa (Gleason score ≥3+4) for each PI-RADS version 2 category was determined. The performance of PI-RADS version 2 in cancer detection was evaluated. Results For PI-RADS category 2 lesions, the overall proportion of cancers was 4% (one of 25), without any clinically important cancer. For PI-RADS category 3, 4, and 5 lesions, the overall proportion of cancers was 22.2% (78 of 352), 39.1% (43 of 110), and 87.8% (129 of 147), respectively, and the proportion of clinically important cancers was 11.1% (39 of 352), 29.1% (32 of 110), and 77.6% (114 of 147), respectively. Higher PI-RADS version 2 scores were associated with increasing likelihood of the presence of clinically important PCa (P < .001). Differences were found in the percentage of cancers in the PI-RADS category between PI-RADS 3 and those upgraded to PI-RADS 4 based on diffusion-weighted imaging for clinically important cancers (proportion for clinically important cancers for PI-RADS 3 and PI-RADS 3+1 were 11.1% [39 of 352] and 30.8% [28 of 91], respectively; P < .001). Conclusion Higher PI-RADS version 2 scores are associated with a higher proportion of clinically important cancers in the TZ. PI-RADS category 2 lesions rarely yield PCa, and their presence does not justify targeted biopsy.

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Section: Discussionmentioning

confidence: 96%

Validation of PI-RADS Version 2 in Transition Zone Lesions for the Detection of Prostate Cancer

Thai¹,

Narayanan

George

et al. 2018

Radiology

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“…A 5-point scoring is used for T2W and DWI with, a 2-point scale (positive or negative) for DCE. DCE is helpful only in the indeterminate category 3 peripheral zone (PZ) lesions (15,16). In our study, we used DWI score as the final score.…”

Section: Discussionmentioning

confidence: 99%

PI-RADS v2 in Prostate Cancer and Correlation with T Staging, PSA Levels and ADC Values

et al. 2017

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Background: Magnetic resonance imaging of the prostate is a major diagnostic tool in prostate cancer detection. In 2012, prostate imaging reporting and data system (PI-RADS) was published by the European society of urogenital radiology. Due to certain limitations in this version, a revised version named Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) was proposed by the American College of Radiology in 2014 Objectives: To evaluate the role of multiparametric magnetic resonance imaging based prostate imaging reporting and data system (PI-RADS) version 2 for the assessment of peripheral zone prostate cancer and its correlation with the T staging, prostatic specific antigen (PSA) levels and apparent diffusion coefficient (ADC) values. Patients and Methods: Eighty seven patients underwent MRI at 1.5 T units. Dynamic contrast enhanced (DCE) imaging was done in 73 patients as 14 patients had deranged renal functions. Patients with a PI-RADS v2 score of ≥ 2 underwent biopsy except in one patient with a score of 1. The histopathological report was used as gold standard. T staging was done based on MRI. The score was correlated with T staging, ADC values and serum prostate-specific antigen (S.PSA) levels by two experienced blinded radiologists. Statistical analysis was done. Results: Highly significant correlation was observed between PI-RADS v2 score, T staging, ADC values and s PSA levels with P value < 0.005. DCE had added advantage in one patient only for up-gradation of score from 3 to 4. Conclusion: The dominant MR imaging sequence for the peripheral zone prostate cancer is diffusion weighted sequence and the corresponding ADC values, with the role of DCE sequences in doubtful cases only. PI-RADS v2 gives a scoring system on MRI for prostate cancer assessment. It should be routinely incorporated in the reporting protocol. Our study concluded that there is a highly significant correlation between lesion score on PI-RADS v2 with the T stage, corresponding ADC values and S.PSA levels, although larger study groups may be required for further evaluation and beyond doubt PI-RADS version 3 is already in its earliest stages.

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“…Even if some aspects of this scoring system have been criticized [25] , a recent meta-analysis found that the PI-RADS v2 score was a good predictor for malignancy, with higher pooled sensitivity than the PI-RADS v1 score (0.95 [95% CI: 0.85–0.98] vs. 0.88 [95% CI: 0.80–0.93], p = 0.04) and similar specificity (0.73 [95% CI: 0.47–0.89] vs. 0.75 [95% CI: 0.36–0.94], p = 0.90) [26] . However, the inter-reader reproducibility of the PI-RADS v2 is moderate at best [27] , [28] , [29] , [30] . Consequently, the good results reported in specialized institutions may not be generalized.…”

Section: Interpretation Of Mpmrimentioning

confidence: 97%

The current role of prostate multiparametric magnetic resonance imaging

Rouvière

Moldovan

2019

Asian Journal of Urology

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Prostate multi-parametric magnetic resonance imaging (mpMRI) has shown excellent sensitivity for Gleason ≥7 cancers, especially when their volume is ≥0.5 mL. As a result, performing an mpMRI before prostate biopsy could improve the detection of clinically significant prostate cancer (csPCa) by adding targeted biopsies to systematic biopsies. Currently, there is a consensus that targeted biopsies improve the detection of csPCa in the repeat biopsy setting and at confirmatory biopsy in patients considering active surveillance. Several prospective multicentric controlled trials recently showed that targeted biopsy also improved csPCa detection in biopsy-naïve patients. The role of mpMRI and targeted biopsy during the follow-up of active surveillance remains unclear. Whether systematic biopsy could be omitted in case of negative mpMRI is also a matter of controversy. mpMRI did show excellent negative predictive values (NPV) in the literature, however, since NPV depends on the prevalence of the disease, negative mpMRI findings should be interpreted in the light of a priori risk for csPCa of the patient. Nomograms combining mpMRI findings and classical risk predictors (age, prostate-specific antigen density, digital rectal examination, etc. ) will probably be developed in the future to decide whether a prostate biopsy should be obtained. mpMRI has a good specificity for detecting T3 stage cancers, but its sensitivity is low. It should therefore not be used routinely for staging purposes in low-risk patients. Nomograms combining mpMRI findings and other clinical and biochemical data will also probably be used in the future to better assess the risk of T3 stage disease.

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Standardized Reporting of Prostate MRI: Comparison of the Prostate Imaging Reporting and Data System (PI-RADS) Version 1 and Version 2

Cited by 44 publications

References 31 publications

Validation of PI-RADS Version 2 in Transition Zone Lesions for the Detection of Prostate Cancer

Validation of PI-RADS Version 2 in Transition Zone Lesions for the Detection of Prostate Cancer

PI-RADS v2 in Prostate Cancer and Correlation with T Staging, PSA Levels and ADC Values

The current role of prostate multiparametric magnetic resonance imaging

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