Direct comparison of PI-RADS version 2 and version 1 regarding interreader agreement and diagnostic accuracy for the detection of clinically significant prostate cancer
Direct comparison of PI-RADS version 2 and version 1 regarding interreader agreement and diagnostic accuracy for the detection of clinically significant prostate cancer
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DOI：
10.1016/j.ejrad.2017.07.016
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发表时间：
2017-09-01
影响因子：
3.3
通讯作者：
Donati, Olivio F.
中科院分区：
文献类型：
--
作者：
Becker, Anton S.;Cornelius, Alexander;Donati, Olivio F.
目的：同时评价PI-RADS v2的一致性和诊断准确性，并与v1进行比较。方法：67例患者，平均年龄65.3岁(51.2~78.2岁；PSA6.8 mU/L，0.2~33 mU/L)。使用组内相关系数(ICC)评估每个脉冲序列和PI-RADS总分的读者间一致性。对于非重叠的95%可信区间，差异被认为是显著的。用受试者工作特征曲线下面积(AZ)评价诊断的准确性。结果：V2(ICC2=0.70；95%CI：0.66~0.74)与V1的一致性较好(ICC2=0.64，0.59~0.69)。每象限DWI评分的一致性(ICC1=0.77，ICC2=0.76)以及最终的PI-RADS评分几乎相同(ICC1=ICC2=0.71)。V1和V2之间的诊断准确率在任何读卡器中均无显著差异(p=0.09-0.93)(范围：AZ=0.78-0.88)。结论：PI-RADS评分在类似的诊断性能下，在v2和v1中表现出相似的读者间一致性。V2中DCE解释的简化可能会略微提高符合率，同时不会对诊断性能产生负面影响。
Purpose: to simultaneously evaluate interreader agreement and diagnostic accuracy in the of PI-RADS v2 and compare it to v1.Methods: A total of 67 patients (median age 65.3 y, range 51.2-78.2 y; PSA 6.8 mu g/L, 0.2-33 mu g/L) undergoing MRI of the prostate and subsequent transperineal template biopsy within = 3 months apart. Interreader agreement was assessed for each pulse-sequence and for total PI-RADS scores using the intraclass correlation coefficient (ICC). Differences were considered significant for non-overlapping 95%-confidence intervals. Diagnostic accuracy was assessed with the area under the receiver operating characteristic curve (AZ). A p-value < 0.05 was considered statistically significant.Results: Interreader agreement for DCE-scores was good in v2 (ICC2 = 0.70; 95% CI: 0.66-0.74) and slightly lower in v1 (ICC1 = 0.64, 0.59-0.69). Agreement for DWI scores (ICC1 = 0.77, ICC2 = 0.76) as well as final PI-RADS scores per quadrant were nearly identical (ICC1 = ICC2 = 0.71). Diagnostic accuracy showed no significant differences (p = 0.09-0.93) between v1 and v2 in any of the readers (range: AZ = 0.78-0.88).Conclusion: PI-RADS scores show similar interreader agreement in v2 and v1 at comparable diagnostic performance. The simplification of the DCE interpretation in v2 might slightly improve agreement while not negatively affecting diagnostic performance.