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Comparison of PI-RADS version 2.1 and PI-RADS version 2 regarding interreader variability and diagnostic accuracy for transition zone prostate cancer

  • Special Section: Prostate cancer
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To compare the diagnostic performance of PI-RADS version 2.1 (PI-RADS v2.1) and PI-RADS v2 for transition zone prostate cancer (TZPC), and analyse its performance for readers with different experience levels.

Methods

Eighty-five patients with suspected prostate cancer who underwent biopsy after MRI scan between January and December 2017 were retrospectively enrolled. One junior radiologist (reader 1, 1 year of experience in using PI-RADS v2) and one senior radiologist (reader 2, 6 years of experience) independently reviewed and assigned a score for each lesion according to PI-RADS v2.1 and v2. The template-guided transperineal prostate biopsy was used for standard of reference. To compare the diagnostic performance of the two methods, the AUC was calculated. The sensitivity, specificity, and accuracy were calculated at predefined positive values (PI-RADS ≥ 3). The interreader agreement and frequency of prostate cancer for each PI-RADS category were also calculated.

Results

Among the 85 patients, 27 had prostate cancers, and 25 were clinically significant prostate cancer (csPCa). The AUC values for diagnosing clinically significant prostate cancer significantly increased with PI-RADS v2.1 for reader 2 (0.766 vs. 0.902, P = 0.009). The specificity and accuracy for both readers also increased with PI-RADS v2.1 (specificity: reader 1, 41.7% vs. 78.3% and reader 2, 33.3% vs. 81.7%; accuracy: reader 1, 52.9% vs. 76.5% and reader 2, 48.2% vs. 83.5%, all P < 0.05). The interreader agreement was good for both versions. The percentage of prostate cancer decreased in lower PI-RADS categories (PI-RADS 2) and increased in higher PI-RADS categories (PI-RADS 3 ~ 4).

Conclusion

Compared with PI-RADS v2, PI-RADS v2.1 may improve radiologists’ diagnostic performance for TZPC.

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Availability of data and material

All data generated or analysed during this study are available from the corresponding author on reasonable request.

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Funding

This work was funded by the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences (Grant Number 2019XK320028), the National Natural Science Foundation of China (Grant Number 91859119), the Natural Science Foundation of Beijing Municipality (Grant Number 7192176), and the National Public Welfare Basic Scientific Research Project of Chinese Academy of Medical Sciences (Grant Numbers 2018PT32003 and 2019PT320008).

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Authors and Affiliations

  1. Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Wangfujing Street, Dongcheng District, Beijing, 100730, China

    Lili Xu, Gumuyang Zhang, Daming Zhang, Xiaoxiao Zhang, Xin Bai, Zhengyu Jin & Hao Sun

  2. Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Wangfujing Street, Dongcheng District, Beijing, 100730, China

    Weigang Yan, Yi Zhou & Zhien Zhou

  3. Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Wangfujing Street, Dongcheng District, Beijing, 100730, China

    Yu Xiao

Authors
  1. Lili Xu
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  2. Gumuyang Zhang
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  3. Daming Zhang
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  4. Xiaoxiao Zhang
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  5. Xin Bai
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  7. Yi Zhou
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  8. Zhien Zhou
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  9. Yu Xiao
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  10. Zhengyu Jin
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  11. Hao Sun
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Correspondence to Zhengyu Jin or Hao Sun.

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All authors declare that they have no conflict of interest.

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The Institutional Review Board approved this study.

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Written informed consent was waived in view of the retrospective nature of the study.

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Hao Sun is the primary corresponding author and Zhengyu Jin is the secondary corresponding author.

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Xu, L., Zhang, G., Zhang, D. et al. Comparison of PI-RADS version 2.1 and PI-RADS version 2 regarding interreader variability and diagnostic accuracy for transition zone prostate cancer. Abdom Radiol 45, 4133–4141 (2020). https://doi.org/10.1007/s00261-020-02738-6

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  • DOI: https://doi.org/10.1007/s00261-020-02738-6

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