Title |
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
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Published in |
European Radiology, September 2015
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DOI | 10.1007/s00330-015-4015-6 |
Pubmed ID | |
Authors |
H. A. Vargas, A. M. Hötker, D. A. Goldman, C. S. Moskowitz, T. Gondo, K. Matsumoto, B. Ehdaie, S. Woo, S. W. Fine, V. E. Reuter, E. Sala, H. Hricak |
Abstract |
To evaluate the recommendations for multiparametric prostate MRI (mp-MRI) interpretation introduced in the recently updated Prostate Imaging Reporting and Data System version 2 (PI-RADSv2), and investigate the impact of pathologic tumour volume on prostate cancer (PCa) detectability on mpMRI. This was an institutional review board (IRB)-approved, retrospective study of 150 PCa patients who underwent mp-MRI before prostatectomy; 169 tumours ≥0.5-mL (any Gleason Score [GS]) and 37 tumours <0.5-mL (GS ≥4+3) identified on whole-mount pathology maps were located on mp-MRI consisting of T2-weighted imaging (T2WI), diffusion-weighted (DW)-MRI, and dynamic contrast-enhanced (DCE)-MRI. Corresponding PI-RADSv2 scores were assigned on each sequence and combined as recommended by PI-RADSv2. We calculated the proportion of PCa foci on whole-mount pathology correctly identified with PI-RADSv2 (dichotomized scores 1-3 vs. 4-5), stratified by pathologic tumour volume. PI-RADSv2 allowed correct identification of 118/125 (94 %; 95 %CI: 90-99 %) peripheral zone (PZ) and 42/44 (95 %; 95 %CI: 89-100 %) transition zone (TZ) tumours ≥0.5 mL, but only 7/27 (26 %; 95 %CI: 10-42 %) PZ and 2/10 (20 %; 95 %CI: 0-52 %) TZ tumours with a GS ≥4+3, but <0.5 mL. DCE-MRI aided detection of 4/125 PZ tumours ≥0.5 mL and 0/27 PZ tumours <0.5 mL. PI-RADSv2 correctly identified 94-95 % of PCa foci ≥0.5 mL, but was limited for the assessment of GS ≥4+3 tumours ≤0.5 mL. DCE-MRI offered limited added value to T2WI+DW-MRI. • PI-RADSv2 correctly identified 95 % of PCa foci ≥0.5 mL • PI-RADSv2 was limited for the assessment of GS ≥4+3 tumours ≤0.5 mL • DCE-MRI offered limited added value to T2WI+DW-MRI. |
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Geographical breakdown
Country | Count | As % |
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Switzerland | 4 | 44% |
United States | 1 | 11% |
Spain | 1 | 11% |
Austria | 1 | 11% |
Unknown | 2 | 22% |
Demographic breakdown
Type | Count | As % |
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Practitioners (doctors, other healthcare professionals) | 4 | 44% |
Members of the public | 3 | 33% |
Science communicators (journalists, bloggers, editors) | 2 | 22% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 1 | <1% |
Unknown | 180 | 99% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 30 | 17% |
Student > Ph. D. Student | 23 | 13% |
Other | 16 | 9% |
Student > Doctoral Student | 14 | 8% |
Professor > Associate Professor | 14 | 8% |
Other | 50 | 28% |
Unknown | 34 | 19% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 101 | 56% |
Engineering | 7 | 4% |
Nursing and Health Professions | 5 | 3% |
Computer Science | 4 | 2% |
Immunology and Microbiology | 2 | 1% |
Other | 6 | 3% |
Unknown | 56 | 31% |