Application of Prostate Imaging Reporting and Data System Version 2 (PI-RADS V2): Interobserver Agreement and Positive Predictive Value for Localization of Intermediate- and High-Grade Prostate Cancers on Multiparametric Magnetic Resonance Imaging
Application of Prostate Imaging Reporting and Data System Version 2 (PI-RADS V2): Interobserver Agreement and Positive Predictive Value for Localization of Intermediate- and High-Grade Prostate Cancers on Multiparametric Magnetic Resonance Imaging
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DOI：
10.1016/j.acra.2017.03.019
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发表时间：
2017-09-01
影响因子：
4.8
通讯作者：
Palmer, Suzanne
中科院分区：
文献类型：
--
作者：
Chen, Frank;Cen, Steven;Palmer, Suzanne
基本原理和目的：评价观察者间对前列腺癌多参数磁共振成像(MpMRl)多参数磁共振成像(MpMRl)定位的符合性和阳性预测值(PPV)。材料和方法：在这项机构审查委员会批准的回顾性研究中，131名连续接受mpMRl检查的前列腺癌患者接受了经直肠超声-磁共振成像融合引导下的前列腺活检。两位对最初的mpMR1报告、临床数据和病理结果视而不见的读者回顾了MR图像，识别了所有的前列腺病变，并根据PI-RADS v2对每个病变进行了评分。结果：PI-RADS v2在两个不同经验的读者之间具有中等程度的观察者间一致性，对所有病变、周围区病变和移行区病变的ICC分别为0.74、0.72和0.67。尽管观察者间只有中等程度的一致性，但在两个读者之间计算的每一种PI-RADS类别在检测中高度恶性前列腺癌中的PPV非常相似，PI-RADS类别2、3、4和5的PPV分别为0%、12%、%和87%。结论：在我们的研究中，PI-RADS v2只有中度的观察者间一致性，在原始PI-RADS研究和PI-RADS v2的初步研究中得到了类似的发现。尽管如此，PI-RADS v2似乎是一个预测重大前列腺癌的有用系统，PI-RADS评分与中、高级别癌症的可能性有很好的相关性。
Rationale and Objectives: To evaluate interobserver agreement with the use of and the positive predictive value (PPV) of Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) for the localization of intermediate- and high-grade prostate cancers on multiparametric magnetic resonance imaging (mpMRl).Materials and Methods: In this retrospective, institutional review board-approved study, 131 consecutive patients who had mpMRl followed by transrectal ultrasound-MR imaging fusion-guided biopsy of the prostate were included. Two readers who were blinded to initial mpMRl reports, clinical data, and pathologic outcomes reviewed the MR images, identified all prostate lesions, and scored each lesion based on the PI-RADS v2. Interobserver agreement was assessed by intraclass correlation coefficient (ICC), and PPV was calculated for each PI-RADS category.Results: PI-RADS v2 was found to have a moderate level of interobserver agreement between two readers of varying experience, with ICC of 0.74, 0.72, and 0.67 for all lesions, peripheral zone lesions, and transitional zone lesions, respectively. Despite only moderate interobserver agreement, the calculated PPV in the detection of intermediate- and high-grade prostate cancers for each PI-RADS category was very similar between the two readers, with approximate PPV of 0%, 12%, 64%, and 87% for PI-RADS categories 2, 3, 4, and 5, respectively.Conclusions: In our study, PI-RADS v2 has only moderate interobserver agreement, a similar finding in studies of the original PI-RADS and in initial studies of PI-RADS v2. Despite this, PI-RADS v2 appears to be a useful system to predict significant prostate cancer, With PI-RADS scores correlating well with the likelihood of intermediate- and high-grade cancers.