To evaluate the utility of cancer detection rate (CDR) and abnormal interpretation rate (AIR) in prostate MRI for patients with low-grade prostate cancer (PCa).
This three-center retrospective study included patients who underwent prostate MRI from 2017 to 2021 with known low-grade PCa (Gleason score 6) without prior treatment. Patient-level highest PI-RADS score and pathological diagnosis within 1 year after MRI were used to evaluate the diagnostic performance of prostate MRI in detecting clinically significant PCa (csPCa: Gleason score ≥7). The metrics AIR, CDR, and CDR adjusted for pathological confirmation rate (aCDR) were calculated. Radiologist-level AIR-CDR plots were shown. Simulation AIR-CDR lines were created to assess the effects of different diagnostic performances of prostate MRI and the prevalence of csPCa.
A total of 3207 exams were interpreted by 33 radiologists. Overall AIR, CDR, and aCDR at PI-RADS 3-5 (4-5) were 51.7% (36.5%), 22.1% (18.8%), and 30.7% (24.6%), respectively. Radiologist-level AIR and CDR at PI-RADS 3-5 (4-5) were in the 36.8-75.6% (21.9-57.5%) range and the 16.3-28.7% (10.9-26.5%) range. In the simulation, changing parameters of diagnostic performance or csPCa prevalence shifted the AIR-CDR line.
We proposed CDR and AIR as performance metrics in prostate MRI and reported reference performance values in patients with known low-grade PCa. There was variability in radiologist-level AIR and CDR. Combined use of AIR and CDR could provide meaningful feedback for radiologists to improve their performance by showing relative performance to other radiologists.
Journal of the American College of Radiology : JACR. 2023 Oct 12 [Epub ahead of print]
Hirotsugu Nakai, Hiroki Nagayama, Hiroaki Takahashi, Adam T Froemming, Akira Kawashima, Candice W Bolan, Daniel A Adamo, Rickey E Carter, Robert T Fazzio, Shintaro Tsuji, Derek J Lomas, Lance A Mynderse, Mitchell R Humphreys, Chandler Dora, Naoki Takahashi
Department of Radiology, Mayo Clinic, Rochester, MN, United States., Department of Radiology, Mayo Clinic, Rochester, MN, United States; Department of Radiology, Nagasaki University School of Medicine, Nagasaki, Japan., Department of Radiology, Mayo Clinic, Scottsdale, AZ, United States., Department of Radiology, Mayo Clinic, Jacksonville, FL, United States., Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL, United States., Mayo Clinic College of Medicine, Rochester, MN, United States., Department of Urology, Mayo Clinic, Rochester, MN, United States., Department of Urology, Mayo Clinic, Scottsdale, AZ, United States., Department of Urology, Mayo Clinic, Jacksonville, FL, United States., Department of Radiology, Mayo Clinic, Rochester, MN, United States. Electronic address: .