Purpose: The accuracy of multiparametric magnetic resonance imaging (mpMRI) heavily relies on image quality, as evidenced by the evolution of the prostate imaging quality (PI-QUAL) scoring system for the evaluation of clinically significant prostate cancer (csPC). This study aims to evaluate the impact of PI-QUAL scores in detecting csPC within PI-RADS 4 and 5 lesions. Methods: We retrospectively selected from our database all mpMRI performed from January 2019 to March 2022. Inclusion criteria were as follows: (1) mpMRI acquired in our institution according to the technical requirements from the PI-RADS (v2.1) guidelines; (2) single lesion scored as PI-RADS (v2.1) 4 or 5; (3) MRI-TBx performed in our institution; (4) complete histology report; and (5) complete clinical record. Results: A total of 257 male patients, mean age 70.42 ± 7.6 years, with a single PI-RADS 4 or 5 lesion undergoing MRI-targeted biopsy, were retrospectively studied. Of these, 61.5% were PI-RADS 4, and 38.5% were PI-RADS 5, with 84% confirming neoplastic cells. In high-quality image lesions (PI-QUAL ≥ 4), all PI-RADS 5 lesions were accurately identified as positive at the final histological examination (100% of CDR). For PI-RADS 4 lesions, 37 (23%) were negative, resulting in a cancer detection rate of 77% (95% CI: 67.51-84.83). Conclusions: The accuracy of mpMRI, independently of the PI-RADS score, progressively decreased according to the decreasing PI-QUAL score. These findings emphasize the crucial role of the PI-QUAL scoring system in evaluating PI-RADS 4 and 5 lesions, influencing mpMRI accuracy.
Journal of clinical medicine. 2024 Jun 27*** epublish ***
Andrea Fuschi, Paolo Pietro Suraci, Antonio Luigi Pastore, Yazan Al Salhi, Paola Capodiferro, Silvio Scalzo, Onofrio Antonio Rera, Fabio Maria Valenzi, Michele Di Dio, Pierluigi Russo, Mohammad Talal Al-Zubi, Saddam Al Demour, Samer Fathi Al-Rawashdah, Giorgio Mazzon, Davide Bellini, Iacopo Carbone, Vincenzo Petrozza, Giorgio Bozzini, Alessandro Zucchi, Matteo Pacini, Giorgia Tema, Cosimo De Nunzio, Antonio Carbone, Marco Rengo
Unit of Urology, Department of Medical-Surgical Sciences and Biotechnologies, I.C.O.T. Hospital, University of Rome Sapienza, Via F. Faggiana 1668, 04100 Latina, Italy., Department of Radiological, Oncological and Pathological Sciences, Academic Diagnostic, Imaging Division, I.C.O.T. Hospital, University of Rome Sapienza, Via F. Faggiana 1668, 04100 Latina, Italy., Division of Urology, Department of Surgery, Annunziata Hospital, 87100 Cosenza, Italy., Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy., Department of Surgery, Division of Urology, School of Medicine, Yarmouk University, Irbid 21110, Jordan., Department of Special Surgery, Division of Urology, School of Medicine, The University of Jordan, Amman 11972, Jordan., Department of Special Surgery, Urology Unit, School of Medicine, Mutah University, Karak 61710, Jordan., Institute of Urology, University College Hospital, London NW12BU, UK., Pathology Unit, Department of Medical-Surgical Sciences and Biotechnologies, I.C.O.T. Hospital, University of Rome Sapienza, Via F. Faggiana 1668, 04100 Latina, Italy., Division of Urology, Sant'Anna Hospital, San Fermo della Battaglia, 22042 Como, Italy., Department of Urology, University of Pisa, 56126 Pisa, Italy., Department of Urology, Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.