Validation of Prostate Imaging Reporting and Data System Version 2 Using an MRI-Ultrasound Fusion Biopsy in Prostate Cancer Diagnosis
Validation of Prostate Imaging Reporting and Data System Version 2 Using an MRI-Ultrasound Fusion Biopsy in Prostate Cancer Diagnosis
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DOI：
10.2214/ajr.16.17629
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发表时间：
2017-10-01
影响因子：
5
通讯作者：
Cho, Seung Hyun
中科院分区：
文献类型：
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作者：
Kim, See Hyung;Choi, Mi Sun;Cho, Seung Hyun
OBJECTIVE.本研究的目的是前瞻性评估前列腺成像报告和数据系统（PI-RADS）第2版使用MRI超声融合活检。本研究纳入了295例连续患者（478处病变），这些患者在2014年12月至2016年9月期间接受了多参数MRI和随后的MRI-超声融合活检。使用PI-RADS第2版的总体评分评估病变。一位放射科医生使用>= 4和>= 3的临界值评估了整个腺体以及外周区和移行区亚组中是否存在临床显著的前列腺癌。MRI-超声融合活检标本的组织学检查用作参考标准。计算敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和准确性，以评估PI-RADS第2版诊断临床显著前列腺癌的实用性。PI-RADS第2版的总体评分显示，整个腺体的准确性为82.2%（393/478），临界值>= 4，敏感性为90.0%（90/100），特异性为80.1%（303/378），PPV为83.3%（90/108），NPV为81.8%（303/370）。总体评分显示，外周区和移行区的准确率分别为84.7%（301/355）和74.7%（92/123）。当综合评分≥ 3分时，诊断准确率为68.6%（328/478），敏感性为94.6%（124/131），特异性为58.7%（204/347），阳性预测值为51.6%（124/240），阴性预测值为85.7%（204/238）。PI-RADS第2版在诊断具有临床意义的前列腺癌方面具有总体良好的性能。
OBJECTIVE. The purpose of our study was to prospectively assess Prostate Imaging Reporting and Data System (PI-RADS) version 2 using an MRI-ultrasound fusion biopsy.SUBJECTS AND METHODS. This study included 295 consecutive patients with 478 lesions who underwent multiparametric MRI and subsequent MRI-ultrasound fusion biopsy between December 2014 and September 2016. Lesions were assessed by using an overall score of PI-RADS version 2. One radiologist assessed the presence or absence of clinically significant prostate cancer in the whole gland and in subgroups of the peripheral zone and transition zone by using cutoff values of >= 4 and >= 3. Histologic examination of MRI-ultrasound fusion biopsy specimens was used as the reference standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated to assess the utility of PI-RADS version 2 for the diagnosis of clinically significant prostate cancer.RESULTS. The overall PI-RADS version 2 scores showed an accuracy of 82.2% (393/478) for the whole gland, with a cutoff value of >= 4 granting sensitivity of 90.0% (90/100), specificity of 80.1% (303/378), PPV of 83.3% (90/108), and NPV of 81.8% (303/370). The overall scores showed accuracies of 84.7% (301/355) in the peripheral zone and 74.7% (92/123) in the transition zone. When we applied an arbitrary overall score of >= 3, accuracy was 68.6% (328/478), sensitivity was 94.6% (124/131), specificity was 58.7% (204/347), PPV was 51.6% (124/240), and NPV was 85.7% (204/238).CONCLUSION. PI-RADS version 2 has an overall good performance for the diagnosis of clinically significant prostate cancer.