Comparison of PI-RADS version 2 and PI-RADS version 2.1 for the detection of transition zone prostate cancer
Comparison of PI-RADS version 2 and PI-RADS version 2.1 for the detection of transition zone prostate cancer
复制标题
DOI：
10.1016/j.ejrad.2019.108704
复制
发表时间：
2019-12-01
影响因子：
3.3
通讯作者：
Sone, Teruki
中科院分区：
文献类型：
--
作者：
Tamada, Tsutomu;Kido, Ayumu;Sone, Teruki
目的：比较PI-RADS v2和v2.1在多参数前列腺MRI（mpMRI）上检测移行区前列腺癌（TZPC）的诊断性能。方法：58例PSA水平升高的患者在3 T下接受mpMRI，包括T2加权成像（T2 WI）和弥散加权成像（DWI），随后进行MRI-经直肠超声融合引导前列腺靶向活检（MRGB）。参考标准是MRGB衍生的组织病理学。两名阅片师独立评估了每个TZ病变，T2 WI评分为1-5分，DWI评分为1-5分，根据PI-RADS v2和v2.1进行总体PI-RADS评估类别。比较两种方法在阅片者间一致性、诊断敏感性、诊断特异性和ROC曲线下面积（AUC）方面的诊断性能良性病变32例（GS= 3+ 3，n= 9; GS= 3+ 4，n= 9; GS= 3+ 5，n= 1; GS= 4+ 3，n= 4; GS= 4+ 4，n= 3）。关于总体PI-RADS评估类别的阅片者间一致性，v2的kappa值为0.580，v2.1为0.645。对于两位阅片师，两个版本之间的诊断灵敏度没有差异（p >= 0.500）。对于阅片人1，v2.1的诊断特异性较高（p= 0.002），阅片人2的诊断特异性相似（p= 1.000）。对于两名阅片者，v2.1的AUC往往高于v2，但差异不显著（阅片者1为0.786 vs. 0.847，p= 0.052;阅片者2为0.808 vs. 0.858，p= 0.197）。结论：这些结果表明，与PI-RADS v2相比，PI-RADS v2.1更适合用于评价TZ病变。
Purpose: To compare the diagnostic performance of PI-RADS v2 and v2.1 for detecting transition zone prostate cancer (TZPC) on multiparametric prostate MRI (mpMRI).Method: Fifty-eight patients with elevated PSA levels underwent mpMRI at 3 T including T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI), and subsequent MRI-transrectal ultrasonography fusion-guided prostate-targeted biopsy (MRGB). The standard of reference was MRGB-derived histopathology. Two readers independently assessed each TZ lesion, assigning a score of 1-5 for T2WI, a score of 1-5 for DWI, and the overall PI-RADS assessment category according to PI-RADS v2 and v2.1. The diagnostic performance of the two methods was compared in terms of inter-reader agreement, diagnostic sensitivity, diagnostic specificity, and area under the ROC curve (AUC).Results: Of the 58 patients, 26 were diagnosed with PC (GS= 3+ 3, n= 9; GS= 3+ 4, n= 9; GS= 3+ 5, n= 1; GS= 4+ 3, n= 4; GS= 4+ 4, n= 3) and 32 with benign lesions. Regarding inter-reader agreement of overall PI-RADS assessment category, the kappa value was 0.580 for v2 and 0.645 for v2.1. For both readers, there was no difference in diagnostic sensitivity between the versions (p >= 0.500). For reader 1, the diagnostic specificity was higher for v2.1 (p= 0.002), and was similar for reader 2 (p= 1.000). For both readers, AUC tended to be higher for v2.1 than for v2, but the difference was not significant (0.786 vs. 0.847 for reader 1, p= 0.052; and 0.808 vs. 0.858 for reader 2, p= 0.197).Conclusions: These results suggest that compared with PI-RADS v2, PI-RADS v2.1 could be preferable for evaluating TZ lesions.