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Evaluation of the ESUR PI-RADS scoring system for multiparametric MRI of the prostate with targeted MR/TRUS fusion-guided biopsy at 3.0 Tesla

An Erratum to this article was published on 07 February 2014

Abstract

Objectives

To evaluate the Prostate Imaging Reporting and Data System (PI-RADS) proposed by the European Society of Urogenital Radiology (ESUR) for detection of prostate cancer (PCa) by multiparametric magnetic resonance imaging (mpMRI) in a consecutive cohort of patients with magnetic resonance/transrectal ultrasound (MR/TRUS) fusion-guided biopsy.

Methods

Suspicious lesions on mpMRI at 3.0 T were scored according to the PI-RADS system before MR/TRUS fusion-guided biopsy and correlated to histopathology results. Statistical correlation was obtained by a Mann–Whitney U test. Receiver operating characteristics (ROC) and optimal thresholds were calculated.

Results

In 64 patients, 128/445 positive biopsy cores were obtained out of 95 suspicious regions of interest (ROIs). PCa was present in 27/64 (42 %) of the patients. ROC results for the aggregated PI-RADS scores exhibited higher areas under the curve compared to those of the Likert score. Sensitivity/specificity for the following thresholds were calculated: 73 %/92 % and 85 %/67 % for PI-RADS scores of 9 and 10, respectively; 85 %/56 % and 60 %/97 % for Likert scores of 3 and 4, respectively.

Conclusions

The standardised ESUR PI-RADS system is beneficial to indicate the likelihood of PCa of suspicious lesions on mpMRI. It is also valuable to identify locations to be targeted with biopsy. The aggregated PI-RADS score achieved better results compared to the single five-point Likert score.

Key points

The ESUR PI-RADS scoring system was evaluated using multiparametric 3.0-T MRI.

To investigate suspicious findings, transperineal MR/TRUS fusion-guided biopsy was used.

PI-RADS can guide biopsy locations and improve detection of clinically significant cancer.

Biopsy procedures can be optimised, reducing unnecessary negative biopsies for patients.

The PI-RADS scoring system may contribute to more effective prostate MRI.

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Abbreviations

ADC:

apparent diffusion coefficient

BI-RADS:

Breast Imaging Reporting and Data System

CI:

confidence interval

DCE:

dynamic contrast enhanced

DICOM:

Digital Imaging and Communication in Medicine

DRE:

digital rectal examination

DWI:

diffusion-weighted imaging

ESUR:

European Society of Urogenital Radiology

HASTE:

half-Fourier acquisition turbo spin echo

MRI:

magnetic resonance imaging

MRS:

magnetic resonance spectroscopy

PCa:

prostate cancer

PI-RADS:

Prostate Imaging Reporting and Data System

PSA:

prostate specific antigen

ROC:

receiver operating characteristic

T1w:

T1-weighted

T2w:

T2-weighted

TRUS:

transrectal ultrasound

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Correspondence to M. C. Roethke.

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Roethke, M.C., Kuru, T.H., Schultze, S. et al. Evaluation of the ESUR PI-RADS scoring system for multiparametric MRI of the prostate with targeted MR/TRUS fusion-guided biopsy at 3.0 Tesla. Eur Radiol 24, 344–352 (2014). https://doi.org/10.1007/s00330-013-3017-5

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  • DOI: https://doi.org/10.1007/s00330-013-3017-5

Keywords

  • ESUR score
  • MR/TRUS fusion-guided biopsy
  • Multiparametric MRI
  • PI-RADS
  • Prostate cancer