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The diagnostic performance in clinically significant prostate cancer with PI-RADS version 2.1: simplified bpMRI versus standard mpMRI

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Abstract

Objectives

To compare the diagnostic performance for the detection of clinically significant prostate cancer (csPCa) between bpMRI with only axial T2WI (simplified bpMRI) and standard-multiparametric MRI (mpMRI).

Methods

A total of 569 patients who underwent mpMRI followed by biopsy or prostatectomy were enrolled in this retrospective study. According to PI-RADS v2.1, three radiologists (A, B, C) from three centers blinded to clinical variables were assigned scores on lesions with simplified bpMRI and then with mpMRI 2 weeks later. Diagnostic performance of simplified bpMRI was compared with mpMRI using histopathology as reference standard.

Results

For all the three radiologists, the diagnostic sensitivity was significantly higher with mpMRI than with simplified bpMRI (P < 0.001 to P = 0.035); and although specificity was also higher with mpMRI than with simplified bpMRI for radiologist B and radiologist C, it was statistically significant only for radiologist B (P = 0.011, P = 0.359, respectively). On the contrary, for radiologist A, specificity was higher with simplified bpMRI than with mpMRI (P = 0.001). The area under the receiver operating characteristic curve (AUC) was significantly higher for mpMRI than for simplified bpMRI except for radiologist A (radiologist A: 0.903 vs 0.913, P = 0.1542; radiologist B: 0.861 vs 0.834 P = 0.0013; and radiologist C: 0.884 vs 0.848, P = 0.0003). Interobserver reliability of PI-RADS v2.1 showed good agreement for both simplified bpMRI (kappa = 0.665) and mpMRI (kappa = 0.739).

Conclusion

Although the detection of csPCa with simplified bpMRI was comparatively lower than that with mpMRI, the diagnostic performance was still high in simplified bpMRI. Our data justify using mpMRI outperforms simplified bpMRI for prostate cancer screening and imply simplified bpMRI as a potential screening tool.

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Abbreviations

csPCa:

Clinically significant prostate cancer

PI-RADS v2.1:

Prostate imaging reporting and data system version 2.1

mpMRI:

Multiparametric MRI

bpMRI:

Biparametric MRI

TRUS:

Transrectal ultrasound

PSA:

Prostate-specific antigen

PZ:

Peripheral zone

PHI:

Prostate health index

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Funding

This study was supported by the National Key Research and Development Program of China (No. 2022YFB3203800), Innovative Research Group Project of the National Natural Science Foundation of China (Grant Nos. 82071887, 81671656).

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Authors and Affiliations

  1. Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China

    Jihui Song, Chenglin Zhao, Zhenghan Yang, Zhenchang Wang & Liang Wang

  2. Department of Radiology, Dalian University Affiliated Xinhua Hospital, No.156 Wansui Street, Shahekou District, Dalian, 116021, Liaoning, China

    Jihui Song & Wencai Weng

  3. Department of Radiology, QUFU City People Hospital, No.111 Chunqiu West Road, Qufu, 273100, Shandong, China

    Fei Zhang

  4. Department of Radiology, Ganzhou District People’s Hospital, No.705 Beihuan Road, Ganzhou District, Zhangye, 734000, Gansu, China

    Yingdi Yuan

  5. Carnegie Mellon University, Pittsburgh, USA

    Lee M. Wang

  6. ADK Hospital, Sosun Magu, Male, 20070, Maldives

    Vivek Sah

  7. Department of Radiology, The First Hospital of Qinhuangdao, No.258 Wenhua Road, Haigang District, Qinhuangdao, 066000, Hebei, China

    Jun Zhang

Authors
  1. Jihui Song
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  2. Chenglin Zhao
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Correspondence to Liang Wang.

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Song, J., Zhao, C., Zhang, F. et al. The diagnostic performance in clinically significant prostate cancer with PI-RADS version 2.1: simplified bpMRI versus standard mpMRI. Abdom Radiol 48, 704–712 (2023). https://doi.org/10.1007/s00261-022-03750-8

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  • DOI: https://doi.org/10.1007/s00261-022-03750-8

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