BACKGROUND: The use of multiparametric magnetic resonance imaging (mpMRI) to detect and localize prostate cancer has increased in recent years.
In 2010, the European Society of Urogenital Radiology (ESUR) published guidelines for mpMRI and introduced the Prostate Imaging Reporting and Data System (PI-RADS) for scoring the different parameters.
PURPOSE: To evaluate the reliability and diagnostic performance of endorectal 1.5-T mpMRI using the PI-RADS to localize the index tumor of prostate cancer in patients undergoing prostatectomy.
MATERIAL AND METHODS: This institutional review board IRB-approved, retrospective study included 63 patients (mean age, 60.7 years, median PSA, 8.0). Three observers read mpMRI parameters (T2W, DWI, and DCE) using the PI-RADS, which were compared with the results from whole-mount histopathology that analyzed 27 regions of interest. Inter-observer agreement was calculated as well as sensitivity, specificity, positive predictive value (PPV), and negative predicted value (NPV) by dichotomizing the PI-RADS criteria scores ≥3. A receiver-operating curve (ROC) analysis was performed for the different MR parameters and overall score.
RESULTS: Inter-observer agreement on the overall score was 0.41. The overall score in the peripheral zone achieved sensitivities of 0.41, 0.60, and 0.55 with an NPV of 0.80, 0.84, and 0.83, and in the transitional zone, sensitivities of 0.26, 0.15, and 0.19 with an NPV of 0.92, 0.91, and 0.92 for Observers 1, 2, and 3, respectively. The ROC analysis showed a significantly increased area under the curve (AUC) for the overall score when compared to T2W alone for two of the three observers.
CONCLUSION: 1.5 T mpMRI using the PI-RADS to localize the index tumor achieved moderate reliability and diagnostic performance.
Written by:
Reisæter LA, Fütterer JJ, Halvorsen OJ, Nygård Y, Biermann M, Andersen E, Gravdal K, Haukaas S, Monssen JA, Huisman HJ, Akslen LA, Beisland C, Rørvik J. Are you the author?
Department of Radiology, Haukeland University Hospital, Bergen Norway Department of Clinical Medicine, University of Bergen, Norway; Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Department of Clinical Medicine, University of Bergen, Norway; Department of Pathology, Haukeland University Hospital, Bergen Norway; Department of Urology, Haukeland University Hospital, Bergen Norway; Department of Clinical Engineering, Haukeland University Hospital, Bergen Norway; Department of Pathology, Haukeland University Hospital, Bergen Norway; Department of Clinical Medicine, University of Bergen, Norway.
Reference: Acta Radiol. 2014 May 12. pii: 0284185114531754.
doi: 10.1177/0284185114531754
PubMed Abstract
PMID: 24819231
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