The Prostate Imaging-Reporting and Data System version 2 (PI-RADSv2) scoring system, introduced in 2015, is based on expert consensus. In the same time; frame, a new pathologic scoring system for prostate cancer was introduced by the International Society of Urological Pathology (ISUP).
Our goal was to prospectively evaluate the cancer detection rates for each PI-RADSv2 category and compare to ISUP group scores in patients undergoing systematic biopsy and MRI/transrectal ultrasound fusion-guided biopsy.
339 treatment naïve patients prospectively underwent mpMRI evaluated with PI-RADSv2 with subsequent systematic and fusion-guided biopsy May 2015-May 2016. ISUP scores were applied to pathologic specimens. ISUP≥2 (i.e. Gleason≥ 3+4) was defined as clinically significant prostate cancer. Cancer detection rates were determined for each PI-RADSv2 category as well as for the T2 weighted PIRADSv2; categories in the peripheral zone.
Cancer detection rates for PI-RADSv2 categories 1, 2, 3, 4, 5 were 25%, 20.2%, 24.8%, 39.1%, 86.9% for all prostate cancer, and 0%, 9.6%, 12%, 22.1%, 72.4% for clinically significant prostate cancer. Cancer detection rate in the peripheral zone was significantly higher for T2W MRI PI-RADSv2 category 4 than for overall PIRADSv2; category 4 in the peripheral zone (36.6% vs 48.1%, P=0.001 for all prostate; cancer, 22.9% vs 32.6%, P=0.002 for clinically significant prostate cancer).
Cancer detection rate increases with higher PI-RADSv2 categories.Go “Beyond the Abstract” - Read an article commentary written by the authors
The Journal of urology. 2017 Mar 31 [Epub ahead of print]
Sherif Mehralivand, Sandra Bednarova, Joanna H Shih, Francesca V Mertan, Sonia Gaur, Maria J Merino, Bradford J Wood, Peter A Pinto, Peter L Choyke, Baris Turkbey
Department of Urology and Pediatric Urology, University Medical Center, Mainz, Germany; Urologic Oncology Branch, NCI, NIH, Bethesda, MD, USA; Molecular Imaging Program, NCI, NIH, Bethesda, MD, USA., Molecular Imaging Program, NCI, NIH, Bethesda, MD, USA; Institute of Diagnostic Radiology, Department of Medical and Biological Sciences, University of Udine, Udine, Italy; Center for Interventional Oncology, NCI and Radiology and Imaging Sciences, Clinical Center, NIH, Bethesda, MD, USA., Division of Cancer treatment and Diagnosis: Biometric Research Program, NCI, NIH, Rockville, MD, USA., Molecular Imaging Program, NCI, NIH, Bethesda, MD, USA., Laboratory of Pathology, NCI, NIH, Bethesda, MD, USA., Center for Interventional Oncology, NCI and Radiology and Imaging Sciences, Clinical Center, NIH, Bethesda, MD, USA., Urologic Oncology Branch, NCI, NIH, Bethesda, MD, USA., Molecular Imaging Program, NCI, NIH, Bethesda, MD, USA. Electronic address: .