Inter-reader agreement of the ESUR score for prostate MRI using in-bore MRI-guided biopsies as the reference standard
- 1k Downloads
The recent European Society of Urogenital Radiology (ESUR) guidelines for evaluation and reporting of prostate multiparametric magnetic resonance imaging (mp-MRI) include the Prostate Imaging Reporting and Data System (PI-RADS). The aim of this study was to investigate the inter-reader agreement of this scoring system.
One hundred and sixty-four lesions in 67 consecutive patients with elevated prostate-specific antigen and previously negative trans-rectal ultrasound (TRUS)-guided biopsy were scored retrospectively by three blinded readers using PI-RADS. Mp-MRI was performed at 3 T using T2-weighted, diffusion-weighted and dynamic contrast-enhanced imagings (T2WI, DWI, DCE-MRI). Histology of all lesions was obtained by in-bore MRI-guided biopsy. Cohen’s kappa statistics were calculated for all readers.
Inter-reader agreement for all lesions was good to moderate (T2WI, κ = 0.55; DWI, κ = 0.64; DCE-MRI, κ = 0.65). For tumour lesions it was good (T2WI, κ = 0.66; DWI, κ = 0.80; DCE-MRI, κ = 0.63) and for benign lesions moderate to good (T2WI, κ = 0.46; DWI, κ = 0.52; DCE-MRI, κ = 0.67). Using an overall PI-RADS score with a threshold of ≥10, we achieved a sensitivity of 85.7 %, and negative predictive value of 90.1 % for biopsied lesions.
PI-RADS score shows good to moderate inter-reader agreement and enables standardised evaluation of prostate mp-MRI, with high sensitivity and negative predictive value.
• The European Society of Urogenital Radiology recently published guidelines for prostate MRI.
• We have evaluated inter-reader agreement of ESUR scoring for multiparametric prostate MRI.
• PI-RADS shows good to moderate inter-reader agreement and is clinically applicable.
• PI-RADS achieves in our series high sensitivity and negative predictive value for biopsied lesions.
• PI-RADS can be used as standardised scoring system in prostate cancer detection.
KeywordsProstate cancer Prostate MRI PI-RADS ESUR Scoring MRI-guided biopsy
European Society of Urogenital Radiology
Prostate Imaging Reporting and Data System
Multiparametric magnetic resonance imaging
Dynamic contrast-enhanced imaging
- 1.Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM (2010) GLOBOCAN 2008 v2.0, cancer incidence and mortality worldwide: IARC CancerBase No. 10. International Agency for Research on Cancer, Lyon, France. Available via http://globocan.iarc.fr. Accessed 15. January 2013
- 12.American College of Radiology (2003) Breast Imaging Reporting and Data System (BI-RADS), Breast Imaging Atlas, 4th edn. American College of Radiology (ACR), RestonGoogle Scholar
- 15.“Interdisziplinären Leitlinie der Qualität S3 zur Früherkennung, Diagnose und Therapie der verschiedenen Stadien des Prostatakarzinoms”. Available via http://www.awmf.org/leitlinien/detail/ll/043-022OL.html. Accessed 01. April 2013
- 20.Franiel T, Stephan C, Erbersdobler A, Dietz E, Maxeiner A et al (2011) Areas suspicious for prostate cancer: MR-guided biopsy in patients with at least one transrectal US-guided biopsy with a negative finding—multiparametric MR imaging for detection and biopsy planning. Radiology 259:162–172PubMedCrossRefGoogle Scholar
- 24.Arsov C, Quentin M, Rabenalt R, Antoch G, Albers P, Blondin D (2012) Repeat transrectal ultrasound biopsies with additional targeted cores according to results of functional prostate MRI detects high-risk prostate cancer in patients with previous negative biopsy and increased PSA—a pilot study. Anticancer Res 32:1087–1092PubMedGoogle Scholar
- 29.Bratan F, Niaf E, Melodelima C, Chesnais AL, Souchon R, Mège-Lechevallier F, Colombel M, Rouvière O (2013) Influence of imaging and histological factors on prostate cancer detection and localisation on multiparametric MRI: a prospective study. Eur Radiol. doi: 10.1007/s00330-013-2795-0 PubMedGoogle Scholar
- 30.Chesnais AL, Niaf E, Bratan F, Mège-Lechevallier F, Roche S, Rabilloud M, Colombel M, Rouvière O (2013) Differentiation of transitional zone prostate cancer from benign hyperplasia nodules: evaluation of discriminant criteria at multiparametric MRI. Clin Radiol 68:e323–e330PubMedCrossRefGoogle Scholar