Comparison of the Prostate Imaging Reporting and Data System (PI-RADS) Version 1 and 2 in a Cohort of 245 Patients with Histopathological Reference and Long Term Follow-Up.

Pieter Julien Luc De Visschere; Eva Pattyn; Piet Ost; Tom Claeys; Nicolaas Lumen; Geert Villeirs

doi:10.5334/jbr-btr.1147

Abstract

Objective: To compare the performance of PI-RADSv2 with PI-RADSv1 in patients with elevated PSA before biopsy. Methods: 245 patients with elevated PSA underwent mpMRI before biopsy between May 2011 and December 2014 at 3.0 Tesla without endorectal coil. Patients underwent transrectal ultrasound guided systematic 12 core biopsy followed by radical prostatectomy (N=68), radiation therapy (N=91) or clinical follow-up for at least 2 years (N=86). All exams were scored on a per patient base according to PI-RADSv1 and PI-RADSv2. ClinsigPC was defined as Gleason score ≥7 (including 3+4 with prominent but not predominant Gleason 4 component), and/or tumour volume of ≥0.5cc, and/or tumour stage ≥T3a. Results: In 144 patients (58.8%) a ClinsigPC was found within 2 years after mpMRI. The PI-RADSv1 and PI-RADSv2 overall assessment scores were significantly higher (P<0.001) in patients with ClinsigPC as compared to patients without ClinsigPC. ROC analysis showed an area under the curve of 0.82 (CI 0.76-0.87) for PI-RADSv1 and 0.79 (CI 0.73-0.85) for PI-RADSv2 (P: NS). A threshold score of 3 exhibited sensitivities of 88.2% and 79.2% (P=0.001) and specificities of 64.4% and 67.3% (P: NS) with PI-RADSv1 and PI-RADSv2, respectively. Conclusions: The mpMRI scoring systems PI-RADSv1 and PI-RADSv2 yield similar accuracy to detect ClinsigPC in patients with elevated PSA, although clinicians should be aware that when an overall assessment score of 3 is used as a threshold for a positive mpMRI, PI-RADSv2 has lower sensitivity than PI-RADSv1.

References

Siegel RL Miller KD Jemal A Cancer statistics, 2015 CA Cancer J Clin 2015 65 1 5 29 10.3322/caac.21254
Open DOI Search in Google Scholar Back to article
Barentsz JO Richenberg J Clements R Choyke P Verma S Villeirs G ESUR prostate MR guidelines 2012 Eur Radiol 2012 22 4 746 57 10.1007/s00330-011-2377-y
Open DOI Search in Google Scholar Back to article
Junker D Schafer G Edlinger M Kremser C Bektic J Horninger W Evaluation of the PI-RADS scoring system for classifying mpMRI findings in men with suspicion of prostate cancer BioMed research international 2013 2013 252939 10.1155/2013/252939
Open DOI Search in Google Scholar Back to article
Westphalen AC Rosenkrantz AB Prostate imaging reporting and data system (PI-RADS): reflections on early experience with a standardized interpretation scheme for multiparametric prostate MRI AJR American J Roentgenol 2014 202 1 121 3 10.2214/AJR.13.10889
Open DOI Search in Google Scholar Back to article
Weinreb JC Barentsz JO Choyke PL Cornud F Haider MA Macura KJ PI-RADS Prostate Imaging - Reporting and Data System: 2015, Version 2 Eur Urol 2015 10.1016/j.eururo.2015.08.052
Open DOI Search in Google Scholar Back to article
Barentsz JO Weinreb JC Verma S Thoeny HC Tempany CM Shtern F Synopsis of the PI-RADS v2 Guidelines for Multiparametric Prostate Magnetic Resonance Imaging and Recommendations for Use Eur Urol 2015 10.1016/j.eururo.2015.08.038
Open DOI Search in Google Scholar Back to article
Schimmoller L Quentin M Arsov C Hiester A Buchbender C Rabenalt R MR-sequences for prostate cancer diagnostics: validation based on the PI-RADS scoring system and targeted MR-guided in-bore biopsy Eur Radiol 2014 24 10 2582 9 10.1007/s00330-014-3276-9
Open DOI Search in Google Scholar Back to article
Portalez D Mozer P Cornud F Renard-Penna R Misrai V Thoulouzan M Validation of the European Society of Urogenital Radiology scoring system for prostate cancer diagnosis on multiparametric magnetic resonance imaging in a cohort of repeat biopsy patients Eur Urol 2012 62 6 986 96 10.1016/j.eururo.2012.06.044
Open DOI Search in Google Scholar Back to article
Muller BG Shih JH Sankineni S Marko J Rais-Bahrami S George AK Prostate Cancer: Interobserver Agreement and Accuracy with the Revised Prostate Imaging Reporting and Data System at Multiparametric MR Imaging Radiology 2015 277 3 741 50 10.1148/radiol.2015142818
Open DOI Search in Google Scholar Back to article
de Rooij M Hamoen EH Futterer JJ Barentsz JO Rovers MM Accuracy of multiparametric MRI for prostate cancer detection: a meta-analysis AJR Am J Roentgenol 2014 202 2 343 51 10.2214/AJR.13.11046
Open DOI Search in Google Scholar Back to article
Kumar V Jagannathan NR Thulkar S Kumar R Prebiopsy magnetic resonance spectroscopy and imaging in the diagnosis of prostate cancer International journal of urology: official journal of the Japanese Urological Association 2012 19 7 602 13 10.1111/j.1442-2042.2012.02995.x
Open DOI Search in Google Scholar Back to article
Thompson JE Moses D Shnier R Brenner P Delprado W Ponsky L Multiparametric Magnetic Resonance Imaging Guided Diagnostic Biopsy Detects Significant Prostate Cancer and could Reduce Unnecessary Biopsies and Over Detection: A Prospective Study J Urol 2014 10.1016/j.juro.2014.01.014
Open DOI Search in Google Scholar Back to article
Kirkham AP Emberton M Allen C How good is MRI at detecting and characterising cancer within the prostate? Eur Urol 2006 50 6 1163 74 10.1016/j.eururo.2006.06.025 discussion 75
Open DOI Search in Google Scholar Back to article
Delongchamps NB Rouanne M Flam T Beuvon F Liberatore M Zerbib M Multiparametric magnetic resonance imaging for the detection and localization of prostate cancer: combination of T2-weighted, dynamic contrast-enhanced and diffusion-weighted imaging BJU international 2011 107 9 1411 8 10.1111/j.1464-410X.2010.09808.x
Open DOI Search in Google Scholar Back to article
Villeirs GM Oosterlinck W Vanherreweghe E De Meerleer GO A qualitative approach to combined magnetic resonance imaging and spectroscopy in the diagnosis of prostate cancer Eur J Radiol 2010 73 2 352 6 10.1016/j.ejrad.2008.10.034
Open DOI Search in Google Scholar Back to article
Arumainayagam N Ahmed HU Moore CM Freeman A Allen C Sohaib SA Multiparametric MR imaging for detection of clinically significant prostate cancer: a validation cohort study with transperineal template prostate mapping as the reference standard Radiology 2013 268 3 761 9 10.1148/radiol.13120641
Open DOI Search in Google Scholar Back to article
Kuru TH Roethke MC Rieker P Roth W Fenchel M Hohenfellner M Histology core-specific evaluation of the European Society of Urogenital Radiology (ESUR) standardised scoring system of multiparametric magnetic resonance imaging (mpMRI) of the prostate BJU international 2013 112 8 1080 7 10.1111/bju.12259
Open DOI Search in Google Scholar Back to article
Roethke MC Kuru TH Schultze S Tichy D Kopp-Schneider A Fenchel M Evaluation of the ESUR PI-RADS scoring system for multiparametric MRI of the prostate with targeted MR/TRUS fusion-guided biopsy at 3.0 Tesla Eur Radiol 2014 24 2 344 52 10.1007/s00330-013-3017-5
Open DOI Search in Google Scholar Back to article
Schimmoller L Quentin M Arsov C Lanzman RS Hiester A Rabenalt R Inter-reader agreement of the ESUR score for prostate MRI using in-bore MRI-guided biopsies as the reference standard Eur Radiol 2013 23 11 3185 90 10.1007/s00330-013-2922-y
Open DOI Search in Google Scholar Back to article
Rosenkrantz AB Kim S Lim RP Hindman N Deng FM Babb JS Prostate cancer localization using multiparametric MR imaging: comparison of Prostate Imaging Reporting and Data System (PI-RADS) and Likert scales Radiology 2013 269 2 482 92 10.1148/radiol.13122233
Open DOI Search in Google Scholar Back to article
Hamoen EH de Rooij M Witjes JA Barentsz JO Rovers MM Use of the Prostate Imaging Reporting and Data System (PI-RADS) for Prostate Cancer Detection with Multiparametric Magnetic Resonance Imaging: A Diagnostic Meta-analysis Eur Urol 2015 67 6 1112 21 10.1016/j.eururo.2014.10.033
Open DOI Search in Google Scholar Back to article
Rosenkrantz AB Ginocchio LA Cornfeld D Froemming AT Gupta RT Turkbey B Interobserver Reproducibility of the PI-RADS Version 2 Lexicon: A Multicenter Study of Six Experienced Prostate Radiologists Radiology 2016 152542 10.1148/radiol.2016152542
Open DOI Search in Google Scholar Back to article
Vargas HA Hotker AM Goldman DA Moskowitz CS Gondo T Matsumoto K Updated prostate imaging reporting and data system (PIRADS v2) recommendations for the detection of clinically significant prostate cancer using multiparametric MRI: critical evaluation using whole-mount pathology as standard of reference Eur Radiol 2015 10.1007/s00330-015-4015-6
Open DOI Search in Google Scholar Back to article
Vache T Bratan F Mege-Lechevallier F Roche S Rabilloud M Rouviere O Characterization of prostate lesions as benign or malignant at multiparametric MR imaging: comparison of three scoring systems in patients treated with radical prostatectomy Radiology 2014 272 2 446 55 10.1148/radiol.14131584
Open DOI Search in Google Scholar Back to article
Rosenkrantz AB Lim RP Haghighi M Somberg MB Babb JS Taneja SS Comparison of interreader reproducibility of the prostate imaging reporting and data system and likert scales for evaluation of multiparametric prostate MRI AJR Am J Roentgenol 2013 201 4 W612 8 10.2214/AJR.12.10173
Open DOI Search in Google Scholar Back to article
Rabbani F Stroumbakis N Kava BR Cookson MS Fair WR Incidence and clinical significance of false-negative sextant prostate biopsies J Urol 1998 159 4 1247 50 10.1016/S0022-5347(01)63574-2
Open DOI Search in Google Scholar Back to article

Comparison of the Prostate Imaging Reporting and Data System (PI-RADS) Version 1 and 2 in a Cohort of 245 Patients with Histopathological Reference and Long Term Follow-Up.

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