Assessment of PI-RADS v2 categories ≥ 3 for diagnosis of clinically significant prostate cancer

Nayana U. Patel, Kimberly E. Lind, Kavita Garg, David Crawford, Priya N. Werahera, Sajal S. Pokharel

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Purpose: To assess the diagnostic accuracy of PI-RADS v2 categories ≥ 3 to detect clinically significant prostate cancer (csPCa) against histopathology of Transperineal Mapping Biopsy (TPMB). Materials and methods: IRB-approved retrospective cohort study included 47 men who had 3.0 T multi-parametric MRI (mpMRI) and TPMB of prostate. Two radiologists independently evaluated T2, DWI, ADC map, and DCE images using PI-RADS v2 categories. A third radiologist served as tie-breaker. PI-RADS v2 score (PS) ≥ 3 lesions were correlated with 3D model of TPMB (3DTPMB) results based on prostate sectors. Two groups of csPCa status were separately analyzed for accuracy measures at lesion and person levels: Group 1 with GS (Gleason Score) ≥ 7 and group 2 with tumor volume ≥ 0.5 cc. Inter-rater reliability for PS and MR lexicon was calculated. Results: Forty-seven patients with 3DTPMB had at least one lesion with PS ≥ 3 on mpMRI. PS of 5 had high PPV and high specificity of 100% at the lesion and person levels. Sensitivity of a PS ≥ 3 was 68.27% for group 1 and was 48.39% for group 2. Specificity was 93.56% for group 1 and was 95.53% for group 2. At the person level, sensitivity of PS ≥ 3 was 81.25% for group 1 and was 82.35% for group 2. Specificity was 32.26% for group 1 and was 53.85% for group 2. Conclusion: PI-RADS v2 category of 5 had high PPV and specificity; however, combined PS ≥ 3 had mixed performance in detection of csPCa.

LanguageEnglish
Pages705-712
Number of pages8
JournalAbdominal Radiology
Volume44
Issue number2
Early online date31 Aug 2018
DOIs
Publication statusPublished - 15 Feb 2019
Externally publishedYes

Fingerprint

Prostatic Neoplasms
Biopsy
Prostate
Neoplasm Grading
Research Ethics Committees
Tumor Burden
Cohort Studies
Retrospective Studies
Radiologists

Keywords

  • Clinically significant prostate cancer
  • Multi-parametric MRI
  • PI-RADS v2
  • Prostate cancer
  • Prostate MRI

Cite this

Patel, Nayana U. ; Lind, Kimberly E. ; Garg, Kavita ; Crawford, David ; Werahera, Priya N. ; Pokharel, Sajal S. / Assessment of PI-RADS v2 categories ≥ 3 for diagnosis of clinically significant prostate cancer. In: Abdominal Radiology. 2019 ; Vol. 44, No. 2. pp. 705-712.
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title = "Assessment of PI-RADS v2 categories ≥ 3 for diagnosis of clinically significant prostate cancer",
abstract = "Purpose: To assess the diagnostic accuracy of PI-RADS v2 categories ≥ 3 to detect clinically significant prostate cancer (csPCa) against histopathology of Transperineal Mapping Biopsy (TPMB). Materials and methods: IRB-approved retrospective cohort study included 47 men who had 3.0 T multi-parametric MRI (mpMRI) and TPMB of prostate. Two radiologists independently evaluated T2, DWI, ADC map, and DCE images using PI-RADS v2 categories. A third radiologist served as tie-breaker. PI-RADS v2 score (PS) ≥ 3 lesions were correlated with 3D model of TPMB (3DTPMB) results based on prostate sectors. Two groups of csPCa status were separately analyzed for accuracy measures at lesion and person levels: Group 1 with GS (Gleason Score) ≥ 7 and group 2 with tumor volume ≥ 0.5 cc. Inter-rater reliability for PS and MR lexicon was calculated. Results: Forty-seven patients with 3DTPMB had at least one lesion with PS ≥ 3 on mpMRI. PS of 5 had high PPV and high specificity of 100{\%} at the lesion and person levels. Sensitivity of a PS ≥ 3 was 68.27{\%} for group 1 and was 48.39{\%} for group 2. Specificity was 93.56{\%} for group 1 and was 95.53{\%} for group 2. At the person level, sensitivity of PS ≥ 3 was 81.25{\%} for group 1 and was 82.35{\%} for group 2. Specificity was 32.26{\%} for group 1 and was 53.85{\%} for group 2. Conclusion: PI-RADS v2 category of 5 had high PPV and specificity; however, combined PS ≥ 3 had mixed performance in detection of csPCa.",
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Assessment of PI-RADS v2 categories ≥ 3 for diagnosis of clinically significant prostate cancer. / Patel, Nayana U.; Lind, Kimberly E.; Garg, Kavita; Crawford, David; Werahera, Priya N.; Pokharel, Sajal S.

In: Abdominal Radiology, Vol. 44, No. 2, 15.02.2019, p. 705-712.

Research output: Contribution to journalArticleResearchpeer-review

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AB - Purpose: To assess the diagnostic accuracy of PI-RADS v2 categories ≥ 3 to detect clinically significant prostate cancer (csPCa) against histopathology of Transperineal Mapping Biopsy (TPMB). Materials and methods: IRB-approved retrospective cohort study included 47 men who had 3.0 T multi-parametric MRI (mpMRI) and TPMB of prostate. Two radiologists independently evaluated T2, DWI, ADC map, and DCE images using PI-RADS v2 categories. A third radiologist served as tie-breaker. PI-RADS v2 score (PS) ≥ 3 lesions were correlated with 3D model of TPMB (3DTPMB) results based on prostate sectors. Two groups of csPCa status were separately analyzed for accuracy measures at lesion and person levels: Group 1 with GS (Gleason Score) ≥ 7 and group 2 with tumor volume ≥ 0.5 cc. Inter-rater reliability for PS and MR lexicon was calculated. Results: Forty-seven patients with 3DTPMB had at least one lesion with PS ≥ 3 on mpMRI. PS of 5 had high PPV and high specificity of 100% at the lesion and person levels. Sensitivity of a PS ≥ 3 was 68.27% for group 1 and was 48.39% for group 2. Specificity was 93.56% for group 1 and was 95.53% for group 2. At the person level, sensitivity of PS ≥ 3 was 81.25% for group 1 and was 82.35% for group 2. Specificity was 32.26% for group 1 and was 53.85% for group 2. Conclusion: PI-RADS v2 category of 5 had high PPV and specificity; however, combined PS ≥ 3 had mixed performance in detection of csPCa.

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