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Evaluating the performance of PI-RADS v2 in the non-academic setting

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Abstract

Purpose

To evaluate the utility of PI-RADS v2 to diagnose clinically significant prostate cancer (CS-PCa) with magnetic resonance ultrasound (MR/US) fusion-guided prostate biopsies in the non-academic setting.

Materials/methods

Retrospective analysis of men whom underwent prostate multiparametric MRI and subsequent MR/US fusion biopsies at a single non-academic center from 11/2014 to 3/2016. Prostate MRIs were performed on a 3-Tesla scanner with a surface body coil. The Prostate Imaging Reporting and Data System (PI-RADS) v2 scoring algorithm was utilized and MR/US fusion biopsies were performed in selected cases. Mixed effect logistic regression analyses and receiver-operating characteristic (ROC) curves were performed on PI-RADS v2 alone and combined with PSA density (PSAD) to predict CS-PCa.

Results

170 patients underwent prostate MRI with 282 PI-RADS lesions. MR/US fusion diagnosed 71 CS-PCa, 33 Gleason score 3+3, and 168 negative. PI-RADS v2 score is a statistically significant predictor of CS-PCa (P < 0.001). For each one-point increase in the overall PI-RADS v2 score, the odds of having CS-PCa increases by 4.2 (95% CI 2.2–8.3). The area under the ROC curve for PI-RADS v2 is 0.69 (95% CI 0.63–0.76) and for PI-RADS v2 + PSAD is 0.76 (95% CI 0.69–0.82), statistically higher than PI-RADS v2 alone (P < 0.001). The rate of CS-PCa was about twice higher in men with high PSAD (≥0.15) compared to men with low PSAD (<0.15) when a PI-RADS 4 or 5 lesion was detected (P = 0.005).

Conclusion

PI-RADS v2 is a strong predictor of CS-PCa in the non-academic setting and can be further strengthened when utilized with PSA density.

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Authors and Affiliations

  1. Department of Radiology & Biomedical Imaging, University of California San Francisco, 505 Parnasssus Ave. M-391, San Francisco, CA, 94143, USA

    Eric J. Jordan, Ronald J. Zagoria & Antonio C. Westphalen

  2. RadNet Medical Imaging, Walnut Creek, CA, USA

    Charles Fiske

  3. Department of Radiology & Biomedical Imaging and Urology, University of California San Francisco, San Francisco, CA, USA

    Antonio C. Westphalen

Authors
  1. Eric J. Jordan
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  2. Charles Fiske
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  3. Ronald J. Zagoria
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  4. Antonio C. Westphalen
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Corresponding author

Correspondence to Antonio C. Westphalen.

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Funding

No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

The need for informed consent was waived by the Institutional Review Board.

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Jordan, E.J., Fiske, C., Zagoria, R.J. et al. Evaluating the performance of PI-RADS v2 in the non-academic setting. Abdom Radiol 42, 2725–2731 (2017). https://doi.org/10.1007/s00261-017-1169-5

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  • DOI: https://doi.org/10.1007/s00261-017-1169-5

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