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Performance of PI-RADS version 1 versus version 2 regarding the relation with histopathological results

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Abstract

Purpose

Aim of this study was to compare the diagnostic performance of PI-RADS version 1 (v1) and version 2 (v2) in the detection of prostate cancer (PCa).

Methods

Multiparametric MRIs (mpMRI) of 50 consecutive patients with biopsy proven PCa, which had originally been evaluated according to PIRADS v1, were now retrospectively re-evaluated, comparing PI-RADS v1 and v2. MpMRI data were evaluated in comparison with histopathological whole-mount step-section slides. MRI examinations included T2-weighted, diffusion-weighted, and dynamic contrast-enhanced MRI.

Results

Overall PI-RADS v1 showed a significantly larger discriminative ability of tumor detection: PI-RADS v1 AUC 0.96 (95 % CI 0.94–0.98) and v2 AUC 0.90 (95 % CI 0.86–0.94). For peripheral zone lesions, PI-RADS v1 showed a significantly larger ability of PCa discrimination: v1 AUC 0.97 (95 % CI 0.95–0.99) and v2 AUC 0.92 (95 % CI 0.88–0.96). For transition zone lesions, PI-RADS v1 showed more discrimination: v1 AUC 0.96 (95 % CI 0.92–1.00) and v2 0.90 (95 % CI 0.83–0.97), but the difference was not significant. PI-RADS v2 resulted in significantly more false negative results (3 % in v1, 14 % in v2) and a comparable number of true positive results (82 % in v1, 80 % in v2).

Conclusion

PI-RADS v2 uses a simplified approach, but shows a lower diagnostic accuracy. This could lead to a higher rate of false negative results with the risk of missing tumors within low PI-RADS score levels. Therefore, its use cannot be recommended unconditionally, and further improvement should be considered.

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Authors’ contribution

T Auer was involved in data management and wrote the manuscript. M Edlinger and U Nagele were involved in data analysis and edited the manuscript. J Bektic was involved in data collection. TRW Herrmann was edited the manuscript. G Schäfer was involved in data management. F Aigner was involved in project development. D Junker was involved in project development, data collection and management, data analysis, manuscript writing and editing.

Author information

Authors and Affiliations

  1. Department of Radiology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria

    Thomas Auer, Friedrich Aigner & Daniel Junker

  2. Department of Medical Statistics, Informatics, and Health Economics, Medical University of Innsbruck, Schöpfstraße 41/1, 6020, Innsbruck, Austria

    Michael Edlinger

  3. Department of Urology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria

    Jasmin Bektic

  4. Landeskrankenhaus Hall, Abteilung für Urologie und Andrologie, Milser Straße 10, 6060, Hall in Tirol, Austria

    Udo Nagele

  5. Klinik für Urologie und Urologische Onkologie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Germany

    Thomas Herrmann

  6. Department of Pathology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria

    Georg Schäfer

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  1. Thomas Auer
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Corresponding author

Correspondence to Daniel Junker.

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Conflict of interest

None, nothing to disclose.

Ethical standards

The current manuscript presents a retrospective re-evaluation of patient data. All patient data had originally been collected in the course of a prospective study, which was approved by the local ethics committee in Innsbruck (Study number: AN4468 304/4.17) and has been published in WJUR (Junker et al. [15]). The original study as well as the current retrospective re-evaluation was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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All patients gave their informed consent prior to their inclusion.

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Auer, T., Edlinger, M., Bektic, J. et al. Performance of PI-RADS version 1 versus version 2 regarding the relation with histopathological results. World J Urol 35, 687–693 (2017). https://doi.org/10.1007/s00345-016-1920-5

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  • DOI: https://doi.org/10.1007/s00345-016-1920-5

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