Accuracy and agreement of PIRADSv2 for prostate cancer mpMRI: A multireader study
- 8 July 2016
- journal article
- research article
- Published by Wiley in Journal of Magnetic Resonance Imaging
- Vol. 45 (2), 579-585
- https://doi.org/10.1002/jmri.25372
Abstract
Purpose Multiparametric MRI (mpMRI) improves the detection of clinically significant prostate cancer, but is limited by interobserver variation. The second version of theProstate Imaging Reporting and Data System (PIRADSv2) was recently proposed as a standard for interpreting mpMRI. To assess the performance and interobserver agreement of PIRADSv2 we performed a multi‐reader study with five radiologists of varying experience. Materials and Methods Five radiologists (n = 2 prostate dedicated, n = 3 general body) blinded to clinicopathologic results detected and scored lesions on prostate mpMRI using PIRADSv2. The endorectal coil 3 Tesla MRI included T2W, diffusion‐weighted imaging (apparent diffusion coefficient, b2000), and dynamic contrast enhancement. Thirty‐four consecutive patients were included. Results were correlated with radical prostatectomy whole‐mount histopathology produced with patient‐specific three‐dimensional molds. An index lesion was defined on pathology as the lesion with highest Gleason score or largest volume if equivalent grades. Average sensitivity and positive predictive values (PPVs) for all lesions and index lesions were determined using generalized estimating equations. Interobserver agreement was evaluated using index of specific agreement. Results Average sensitivity was 91% for detecting index lesions and 63% for all lesions across all readers. PPV was 85% for PIRADS ≥ 3 and 90% for PIRADS ≥ 4. Specialists performed better only for PIRADS ≥ 4 with sensitivity 90% versus 79% (P = 0.01) for index lesions. Index of specific agreement among readers was 93% for the detection of index lesions, 74% for the detection of all lesions, and 85% for scoring index lesions, and 58% for scoring all lesions. Conclusion By using PIRADSv2, general body radiologists and prostate specialists can detect high‐grade index prostate cancer lesions with high sensitivity and agreement. Level of Evidence: 1 J. Magn. Reson. Imaging 2017;45:579–585.Keywords
Funding Information
- Intramural Research Program, National Institutes of Health, National Cancer Institute and Clinical Center
- National Institutes of Health (NIH) Medical Research Scholars Program
- NIH
- Pfizer Inc., The Doris Duke Charitable Foundation, The Newport Foundation, The American Association for Dental Research, The Howard Hughes Medical Institute, and the Colgate-Palmolive Company
This publication has 24 references indexed in Scilit:
- Use of the Prostate Imaging Reporting and Data System (PI-RADS) for Prostate Cancer Detection with Multiparametric Magnetic Resonance Imaging: A Diagnostic Meta-analysisEuropean Urology, 2015
- Prostate Imaging Reporting and Data System and Likert Scoring System: Multiparametric MR Imaging Validation Study to Screen Patients for Initial BiopsyRadiology, 2015
- Comparison of MR/Ultrasound Fusion–Guided Biopsy With Ultrasound-Guided Biopsy for the Diagnosis of Prostate CancerJAMA, 2015
- Magnetic Resonance Imaging/Ultrasound–Fusion Biopsy Significantly Upgrades Prostate Cancer Versus Systematic 12-core Transrectal Ultrasound BiopsyEuropean Urology, 2013
- Magnetic Resonance Imaging/Ultrasound Fusion Guided Prostate Biopsy Improves Cancer Detection Following Transrectal Ultrasound Biopsy and Correlates With Multiparametric Magnetic Resonance ImagingJournal of Urology, 2011
- Real‐time Virtual Sonography for navigation during targeted prostate biopsy using magnetic resonance imaging dataInternational Journal of Urology, 2010
- A method for correlating in vivo prostate magnetic resonance imaging and histopathology using individualized magnetic resonance -based moldsReview of Scientific Instruments, 2009
- HOW reliable are change‐corrected measures of agreement?Statistics in Medicine, 1993
- High agreement but low kappa: II. Resolving the paradoxesJournal of Clinical Epidemiology, 1990
- High agreement but low Kappa: I. the problems of two paradoxesJournal of Clinical Epidemiology, 1990