Prospective comparison of PI-RADS version 2 and qualitative in-house categorization system in detection of prostate cancer
Prospective comparison of PI-RADS version 2 and qualitative in-house categorization system in detection of prostate cancer
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DOI：
10.1002/jmri.26025
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发表时间：
2018-11-01
影响因子：
4.4
通讯作者：
Turkbey, Baris
中科院分区：
文献类型：
--
作者：
Gaur, Sonia;Harmon, Stephanie;Turkbey, Baris
背景目的前列腺成像-报告和数据系统第2版（PI-RADSv 2）提供了解释前列腺多参数MRI（mpMRI）的标准化术语。纳入额外的分类功能可能有助于疾病分层。前瞻性比较PI-RADSv 2与用于在mpMRI上检测前列腺癌的定性内部系统。研究类型人群前瞻性。2015年5月至2016年5月共338例患者接受了mpMRI，随后接受了MRI/经直肠超声融合引导活检。场强评估3 T mpMRI（T2 W、扩散加权[DW]、表观扩散系数[ADC]图、B-2000 DWI采集和动态对比增强[DCE] MRI）。一位泌尿生殖科放射科医师使用内部和PI-RADSv 2 5类系统前瞻性地读取mpMRI。计算所有PI-RADSv 2和内部分类的总体和临床显著（CS）肿瘤检出率（TDR）。通过受试者工作特征曲线下面积（AUC）评估每个评分系统检测癌症的能力。在每个PI-RADSv 2分类中，病变进一步按其内部分类分层，以确定结合两种系统的特征是否可以增加TDR。在338例患者中（中位前列腺特异性抗原[PSA] 6.5 [0.6-113.6] ng/mL;年龄64 [44-84]岁），确定了733处病变（47%肿瘤阳性）。两种系统对所有癌症（AUC 76-78%）和CS癌症（AUC 79%）的预测能力相当。对于第3类和第4类，内部系统的总体和CS TDR高于PI-RADSv 2（P
BackgroundPurposeProstate Imaging-Reporting and Data System v. 2 (PI-RADSv2) provides standardized nomenclature for interpretation of prostate multiparametric MRI (mpMRI). Inclusion of additional features for categorization may provide benefit to stratification of disease.To prospectively compare PI-RADSv2 to a qualitative in-house system for detecting prostate cancer on mpMRI.Study TypePopulationProspective.In all, 338 patients who underwent mpMRI May 2015-May 2016, with subsequent MRI/transrectal ultrasound fusion-guided biopsy.Field StrengthAssessment3T mpMRI (T2W, diffusion-weighted [DW], apparent diffusion coefficient [ADC] map, b-2000 DWI acquisition, and dynamic contrast-enhanced [DCE] MRI).One genitourinary radiologist prospectively read mpMRIs using both in-house and PI-RADSv2 5-category systems.Statistical TestResultsIn lesion-based analysis, overall and clinically significant (CS) tumor detection rates (TDR) were calculated for all PI-RADSv2 and in-house categories. The ability of each scoring system to detect cancer was assessed by area under receiver operator characteristic curve (AUC). Within each PI-RADSv2 category, lesions were further stratified by their in-house categories to determine if TDRs can be increased by combining features of both systems.In 338 patients (median prostate-specific antigen [PSA] 6.5 [0.6-113.6] ng/mL; age 64 [44-84] years), 733 lesions were identified (47% tumor-positive). Predictive abilities of both systems were comparable for all (AUC 76-78%) and CS cancers (AUCs 79%). The in-house system had higher overall and CS TDRs than PI-RADSv2 for categories 3 and 4 (P