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Does the Prostate Imaging-Reporting and Data System (PI-RADS) version 2 improve accuracy in reporting anterior lesions on multiparametric magnetic resonance imaging (mpMRI)?

  • Urology - Original Paper
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Abstract

Introduction

Multiparametric MRI (mpMRI) is useful in detecting anterior prostate tumours. Due to the location of anterior tumours, they are often diagnosed with a large size and may be suspicious for extra-prostatic extension (EPE). We aim to evaluate whether PI-RADS v2 is more accurate in assessing anterior prostate lesions identified on mpMRI compared to PI-RADS v1.

Methods

Patients with anterior prostate lesions diagnosed on mpMRI who proceeded to a cognitive fusion transperineal prostate biopsy were identified. Each mpMRI was blinded and read by two experienced prostate MRI radiologists and assigned a PI-RADS v1 and PI-RADS v2 score, and the presence of EPE was estimated. Correlation was made with transperineal histopathology and, where relevant, radical prostatectomy histopathology. Concordance measures between PI-RADS v1 and PI-RADS v2, and between examiners of the same PI-RADS score were calculated using a weighted kappa.

Results

Fifty-eight consecutive men were identified. Concordance between the examiners for PI-RADS v1 and for v2 showed substantial agreement (version 1: weighted kappa 0.71; version 2: weighted kappa 0.69). There was no difference in accuracy when using PI-RADS v1 or PI-RADS v2 to predict clinically significant cancer. There was poor correlation between EPE measured on mpMRI compared with EPE in radical prostatectomy histopathology.

Conclusion

PI-RADS v2 is reproducible between radiologists but does not have improved accuracy for diagnosing anterior tumours of the prostate when compared to PI-RADS v1. Multiparametric MRI is accurate at detecting anterior tumours with a sensitivity of 86–88%.

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Authors and Affiliations

  1. Department of Urology, Lyell McEwin Hospital, Elizabeth Vale, Adelaide, SA, 5112, Australia

    Richard Hoffmann

  2. Department of Urology, Repatriation General Hospital, Adelaide, Australia

    Richard Hoffmann, Callum Logan, Michael O’Callaghan & Darren Foreman

  3. South Australian Prostate Cancer Clinical Outcome Collaborative, Adelaide, Australia

    Michael O’Callaghan

  4. Dr Jones and Partners Medical Imaging, Adelaide, Australia

    Kirsten Gormly & Ken Chan

  5. Discipline of Surgery, University of Adelaide, Adelaide, Australia

    Richard Hoffmann & Darren Foreman

Authors
  1. Richard Hoffmann
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  2. Callum Logan
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  3. Michael O’Callaghan
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  4. Kirsten Gormly
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Correspondence to Richard Hoffmann.

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Hoffmann, R., Logan, C., O’Callaghan, M. et al. Does the Prostate Imaging-Reporting and Data System (PI-RADS) version 2 improve accuracy in reporting anterior lesions on multiparametric magnetic resonance imaging (mpMRI)?. Int Urol Nephrol 50, 13–19 (2018). https://doi.org/10.1007/s11255-017-1753-1

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  • DOI: https://doi.org/10.1007/s11255-017-1753-1

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