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PI-RADS version 2.1 scoring system is superior in detecting transition zone prostate cancer: a diagnostic study

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Abstract

Purpose

The studies comparing the versions 2 vs. 2.1 of the Prostate Imaging Reporting and Data System (PI-RADS) are rare. This study aimed to evaluate whether PI-RADS version 2.1 is superior in detecting transition zone prostate cancer in comparison with PI-RADS version 2.

Methods

This was a diagnostic study of patients with prostate diseases who visited the Urology Department of The Second Affiliated Hospital of Soochow University and underwent a magnetic resonance imaging (MRI) examination between 03-01-2016 and 10-31-2018. The images originally analyzed using PI-RADS version 2 were retrospectively re-analyzed and scored in 2019 according to the updated PI-RADS version 2.1. The kappa and receiver operating characteristic (ROC) curves were used.

Results

For Reader 1, compared with PI-RADS version 2, version 2.1 had higher sensitivity (85% vs. 79%, P = 0.03), lower specificity (65% vs. 83%, P < 0.001), and lower area under the curve (AUC) (0.749 vs. 0.809, P < 0.001). For Reader 2 (first attempt), compared with PI-RADS version 2, version 2.1 had lower specificity (67% vs. 91%, P < 0.001) and lower AUC (0.702 vs. 0.844, P < 0.001). For Reader 2 (second attempt), compared with PI-RADS version 2, version 2.1 had higher sensitivity (88% vs. 78%, P < 0.001) and lower specificity (77% vs. 91%, P < 0.001). The kappa between the two attempts for Reader 2 was 0.321.

Conclusion

These results suggest that PI-RADS version 2.1 might improve the detection of prostate cancers in the transition zone compared with PI-RADS version 2 but that it might results in higher numbers of biopsies because of lower specificity.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This work was supported by grants from Suzhou Minsheng Science and Technology Demonstration Project (SS2019012) and from the National Natural Science Foundation of China Youth Program (81801754). The funding bodies had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.

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Author notes

  1. Zhibing Wang and Wenlu Zhao have contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China

    Zhibing Wang, Wenlu Zhao, Junkang Shen, Zhen Jiang, Shuo Yang, Shuangxiu Tan & Yueyue Zhang

  2. Department of Radiology, Huaian Hospital of Huaian City, Huaian, China

    Zhibing Wang

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  1. Zhibing Wang
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Correspondence to Junkang Shen.

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Wang, Z., Zhao, W., Shen, J. et al. PI-RADS version 2.1 scoring system is superior in detecting transition zone prostate cancer: a diagnostic study. Abdom Radiol 45, 4142–4149 (2020). https://doi.org/10.1007/s00261-020-02724-y

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