European Radiology

, Volume 23, Issue 11, pp 3185–3190 | Cite as

Inter-reader agreement of the ESUR score for prostate MRI using in-bore MRI-guided biopsies as the reference standard

  • L. Schimmöller
  • M. QuentinEmail author
  • C. Arsov
  • R. S. Lanzman
  • A. Hiester
  • R. Rabenalt
  • G. Antoch
  • P. Albers
  • D. Blondin



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.

Key Points

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.


Prostate 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


Spectroscopic imaging


Diffusion-weighted imaging


Prostate-specific antigen


Trans-rectal ultrasound


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Copyright information

© European Society of Radiology 2013

Authors and Affiliations

  • L. Schimmöller
    • 1
  • M. Quentin
    • 1
    Email author
  • C. Arsov
    • 2
  • R. S. Lanzman
    • 1
  • A. Hiester
    • 2
  • R. Rabenalt
    • 2
  • G. Antoch
    • 1
  • P. Albers
    • 2
  • D. Blondin
    • 1
  1. 1.Medical Faculty, Department of Diagnostic and Interventional Radiology, University DusseldorfDusseldorfGermany
  2. 2.Medical Faculty, Department of UrologyUniversity DusseldorfDusseldorfGermany

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