Prostate Imaging-Reporting and Data System Steering Committee: PI-RADS v2 Status Update and Future Directions.
Prostate Imaging-Reporting and Data System Steering Committee: PI-RADS v2 Status Update and Future Directions.
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DOI：
10.1016/j.eururo.2018.05.035
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发表时间：
2019-03
期刊：
影响因子：
23.4
通讯作者：
Barentsz J
中科院分区：
文献类型：
--
作者：
Padhani AR;Weinreb J;Rosenkrantz AB;Villeirs G;Turkbey B;Barentsz J
前列腺成像报告和数据系统（PI-RADS） v2分析系统是基于PI-RADS v1，积累了科学证据和专家共识意见，用于前列腺癌（PCa）的多参数磁共振成像（mpMRI）检测。总结PI-RADS v2的准确性、优点和缺点，讨论其使用的途径含义，并概述改进和未来发展的机会。为了达成PI-RADS指导委员会的共识，临床研究、系统评价和mpMRI PCa检测的专业指南进行了评估。我们专注于PI-RADS v2的性能特征，将数据与基于临床放射学Likert量表和非PI-RADS v2成像的系统进行比较。证据选择基于高质量、前瞻性、组织学验证的数据，患者选择和验证偏差最小。在研究和临床实践中，PI-RADS v2的检测性能比系统经直肠超声（TRUS）活检诊断PCa的准确性更高。PI-RADS v2不能检测到所有的癌症，但可以检测到大多数可能对患者造成伤害的肿瘤，这是不应该错过的。测试表现取决于临床重要疾病的定义和流行程度。在实践中，当诊断过程的质量得到保证时，在训练有素的放射科医生和泌尿科医生的共同努力下，在多学科团队中进行活检程序，就可以获得良好的表现。研究表明，PI-RADS v2在研究和临床实践中的测试性能得到了提高，在诊断前列腺癌时保持了比系统TRUS活检更高的准确性。使用前列腺成像报告和数据系统的多参数磁共振成像（MRI）和MRI指导活检提高了可能造成伤害的前列腺癌的检测，同时减少了如果不治疗不会导致伤害的疾病的检测。成功的关键是高质量的成像、报告和活检，由放射科医生和泌尿科医生在多学科团队中共同工作。
The Prostate Imaging-Reporting and Data System (PI-RADS) v2 analysis system for multiparametric magnetic resonance imaging (mpMRI) detection of prostate cancer (PCa) is based on PI-RADS v1, accumulated scientific evidence, and expert consensus opinion. To summarize the accuracy, strengths and weaknesses of PI-RADS v2, discuss pathway implications of its use and outline opportunities for improvements and future developments. For this consensus expert opinion from the PI-RADS steering committee, clinical studies, systematic reviews, and professional guidelines for mpMRI PCa detection were evaluated. We focused on the performance characteristics of PI-RADS v2, comparing data to systems based on clinicoradiologic Likert scales and non–PI-RADS v2 imaging only. Evidence selections were based on high-quality, prospective, histologically verified data, with minimal patient selection and verifications biases. It has been shown that the test performance of PI-RADS v2 in research and clinical practice retains higher accuracy over systematic transrectal ultrasound (TRUS) biopsies for PCa diagnosis. PI-RADS v2 fails to detect all cancers but does detect the majority of tumors capable of causing patient harm, which should not be missed. Test performance depends on the definition and prevalence of clinically significant disease. Good performance can be attained in practice when the quality of the diagnostic process can be assured, together with joint working of robustly trained radiologists and urologists, conducting biopsy procedures within multidisciplinary teams. It has been shown that the test performance of PI-RADS v2 in research and clinical practice is improved, retaining higher accuracy over systematic TRUS biopsies for PCa diagnosis. Multiparametric magnetic resonance imaging (MRI) and MRI-directed biopsies using the Prostate Imaging-Reporting and Data System improves the detection of prostate cancers likely to cause harm, and at the same time decreases the detection of disease that does not lead to harms if left untreated. The keys to success are high-quality imaging, reporting, and biopsies by radiologists and urologists working together in multidisciplinary teams.
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