Prostate cancer (PCa) histology, particularly the Gleason score, is an independent prognostic predictor in PCa. Little is known about the inter-reader variability in grading of targeted prostate biopsy based on magnetic resonance imaging (MRI). The aim of this study was to assess inter-reader variability in Gleason grading of MRI-targeted biopsy among uropathologists and its potential impact on a population-based randomized PCa screening trial (ProScreen).
From June 2014 to May 2018, 100 men with clinically suspected PCa were retrospectively selected. All men underwent prostate MRI and 86 underwent targeted prostate of the prostate. Six pathologists individually reviewed the pathology slides of the prostate biopsies. The five-tier ISUP (The International Society of Urological Pathology) grade grouping (GG) system was used. Fleiss' weighted kappa (κ) and Model-based kappa for associations were computed to estimate the combined agreement between individual pathologists.
GG reporting of targeted prostate was highly consistent among the trial pathologists. Inter-reader agreement for cancer (GG1-5) vs. benign was excellent (Model-based kappa 0.90, Fleiss' kappa κ = 0.90) and for clinically significant prostate cancer (csPCa) (GG2-5 vs. GG0 vs. GG1), it was good (Model-based kappa 0.70, Fleiss' kappa κ 0.67).
Inter-reader agreement in grading of MRI-targeted biopsy was good to excellent, while it was fair to moderate for MRI in the same cohort, as previously shown. Importantly, there was wide consensus by pathologists in assigning the contemporary GG on MRI-targeted biopsy suggesting high reproducibility of pathology reporting in the ProScreen trial.
World journal of urology. 2024 Apr 06*** epublish ***
Ronja Hietikko, Tuomas Mirtti, Tuomas P Kilpeläinen, Teemu Tolonen, Anne Räisänen-Sokolowski, Stig Nordling, Jill Hannus, Marita Laurila, Kimmo Taari, Teuvo L J Tammela, Reija Autio, Kari Natunen, Anssi Auvinen, Antti Rannikko
Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. ., Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland., Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland., Fimlab Laboratories, Department of Pathology, Tampere University Hospital, Tampere, Finland., HUS Diagnostic Center, Department of Pathology, HUS Helsinki University Hospital, Helsinki, Finland., Department of Pathology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland., Department of Urology, Tampere University Hospital, Tampere, Finland., Faculty of Social Sciences, Tampere University, Tampere, Finland.