Head-to-head comparison of PI-RADS v2 and PI-RADS v1. Issue 6 (June 2016)

• Record Type: Journal Article
• Authors: Polanec, Stephan; Helbich, Thomas H.; Bickel, Hubert; Pinker-Domenig, Katja; Georg, Dietmar; Shariat, Shahrokh F.; Aulitzky, Wolfgang; Susani, Martin; Baltzer, Pascal A.
• Is Part Of: European journal of radiology. Volume 85:Issue 6(2016)
• Page Start: 1125
• Page End: 1131
• Publication Date: 2016-06
• Subjects: Prostate cancer -- Multiparametric MRI -- Standardized reporting -- PI-RADS; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2016.03.025
• Languages: English
• ISSNs: 0720-048X

Abstract

Abstract: Purpose: To compare the reproducibility and diagnostic performance of PI-RADS version 2 (v2) and version 1 (v1) for the diagnosis of prostate cancer (PCa) on multiparametric MRI. Methods: This IRB-approved retrospective study included 65 consecutive biopsy-naïve or biopsy-negative patients suspicious for PCa (mean age: 65 years, mean PSA: 10.8 ng/ml) who were undergoing MR-guided biopsy after multiparametric 3T prostate MRI (T2w, DWI, DCE). Two independent readers (R1 ; R2 ) scored the prostate lesions according to the v2 score and the v1 sum score. Diagnostic measures (sensitivity, specificity, and area under the ROC-curve) were compared for all cases and stratified by location (transitional zone, TZ, peripheral zone, PZ). Inter-reader agreement was assessed by kappa statistics. Results: Inter reader agreement for v2 and v1 was substantial to almost perfect (kappa v2: 0.71, v1: 0.81). Overall, sensitivity between both readers and methods did not differ (p > 0.05). Overall specificity was higher using v1 compared to v2 (R1 : p = 0.0078, R2 : p = 0.0313) In the TZ, v2 showed a higher AUC (0.81–0.84) compared to v1 (AUC 0.77–0.78). Here, the sensitivity of v2 (87.5–100%) was higher than that of v1 (75%) while v2 specificity (50%–56.3%) was lower than that of v1 (68.8–75%). In the PZ, AUCs were higher using v1 (AUC 0.82–0.83) compared to v2 (AUC 0.61–0.63). The specificity for v1 was higher (43.8–62.3%) than that for v2 (12.5–18.8%) while both v2 and v1 achieved 100% sensitivity. Conclusion: PI-RADS v2 and v1 inter-reader agreement is excellent, but their diagnostic performance differs. While v2 appears to be the preferable method for the evaluation of TZ lesions, v1 performs better in the PZ.