Value of an online PI-RADS v2.1 score calculator for assessment of prostate MRI. (2021)

• Record Type: Journal Article
• Authors: Barth, Borna K.; Martini, Katharina; Skawran, Stephan M.; Schmid, Florian A.; Rupp, Niels J.; Zuber, Laura; Donati, Olivio F.
• Is Part Of: European journal of radiology open. Volume 8(2021)
• Publication Date: 2021
• Subjects: Prostate MRI -- Prostate cancer -- PI-RADS 2.1 -- Reporting software; Medical radiology -- Periodicals; 616.075705
• DOI: 10.1016/j.ejro.2021.100332
• Languages: English
• ISSNs: 2352-0477

Abstract

Highlights: A PI-RADS Score Calculator may significantly fasten the reporting process in Prostate MRI. Increased PI-RADS v2.1 reporting speed does not translate into lower diagnostic accuracy. Particularly non-expert radiologists may profit in terms of prostate MRI reporting efficiency. Abstract: Purpose: To evaluate the value of a browser-based PI-RADS Score Calculator (PCalc) compared to MRI reporting using the official PI-RADS v2.1 document (PDoc) for non-specialized radiologists in terms of reporting efficiency, interrater agreement and diagnostic accuracy for detection of clinically significant prostate cancer (PCa). Methods: Between 09/2013 and 04/2015, 100 patients (median age, 64.8; range 47.5−78.2) who underwent prostate-MRI at a 3 T scanner and who received transperineal prostate mapping biopsy within <6 months were included in this retrospective study. Two non-specialized radiology residents (R1, R2) attributed a PI-RADS version 2.1 score for the most suspect (i. e. index) lesion (i) using the original PI-RADS v2.1 document only and after a 6-week interval (ii) using a browser-based PCalc. Reading time was measured. Reading time differences were assessed using Wilcoxon signed rank test. Intraclass-correlation Coefficient (ICC) was used to assess interrater agreement (IRA). Parameters of diagnostic accuracy and ROC curves were used for assessment of lesion-based diagnostic accuracy. Results: Cumulative reading time was 32:55 (mm:ss) faster when using the PCalc, the difference being statistically significant for both readers (p < 0.05). The difference in IRA between the image sets (ICC 0.55 [0.40, 0.68]) and 0.75 [0.65, 0.82] for the image set with PDoc and PCalc, respectively) was not statistically significant. There was no statistically significant difference in lesion-based diagnostic accuracy (AUC 0.83 [0.74, 0.92] and 0.82 [95 %CI: 0.74, 0.91]) for images assessed with PDoc as compared to PCalc (AUC 0.82 [0.74, 0.91] and 0.74 [95 %CI: 0.64, 0.83]) for R1 and R2, respectively. Conclusion: Non-specialized radiologists may increase reading speed in prostate MRI with the help of a browser-based PI-RADS Score Calculator compared to reporting using the official PI-RADS v2.1 document without impairing interreader agreement or lesion-based diagnostic accuracy for detection of clinically significant PCa.