Validation of the Dominant Sequence Paradigm and Role of Dynamic Contrast-enhanced Imaging in PI-RADS Version 2

被引:136
作者
Greer, Matthew D. [1 ]
Shih, Joanna H. [2 ]
Lay, Nathan [5 ]
Barrett, Tristan [6 ]
Bittencourt, Leonardo Kayat [7 ,8 ]
Borofsky, Samuel [9 ]
Kabakus, Ismail M. [10 ]
Law, Yan Mee [11 ]
Marko, Jamie [12 ]
Shebel, Haytham [13 ]
Mertan, Francesca V.
Merino, Maria J. [3 ]
Wood, Bradford J. [14 ,15 ,16 ]
Pinto, Peter A. [4 ]
Summers, Ronald M. [5 ]
Choyke, Peter L. [1 ]
Turkbey, Baris [1 ]
机构
[1] NCI, Mol Imaging Program, NIH, 10 Ctr Dr,Room B3B85, Bethesda, MD 20892 USA
[2] NCI, Biometr Res Program, NIH, 10 Ctr Dr,Room B3B85, Bethesda, MD 20892 USA
[3] NCI, Pathol Lab, NIH, 10 Ctr Dr,Room B3B85, Bethesda, MD 20892 USA
[4] NCI, Urol Oncol Branch, NIH, 10 Ctr Dr,Room B3B85, Bethesda, MD 20892 USA
[5] NIH, Imaging Biomarkers & Comp Aided Diag Lab, Dept Radiol & Imaging Sci, Bldg 10, Bethesda, MD 20892 USA
[6] Univ Cambridge, Sch Med, Dept Radiol, Cambridge, England
[7] Univ Fed Fluminense, Dept Radiol, Rio De Janeiro, Brazil
[8] DASA, CDPI Clin, Dept Body Imaging, Rio De Janeiro, Brazil
[9] George Washington Univ Hosp, Dept Radiol, Washington, DC USA
[10] Hacettepe Univ, Dept Radiol, Ankara, Turkey
[11] Singapore Gen Hosp, Dept Diagnost Radiol, Singapore, Singapore
[12] Walter Reed Natl Mil Med Ctr, Dept Radiol, Bethesda, MD USA
[13] Mansoura Univ, Dept Radiol, Nephrol Ctr, Mansoura, Egypt
[14] NCI, Ctr Intervent Oncol, NIH, Bethesda, MD 20892 USA
[15] NIH, Ctr Clin, Bldg 10, Bethesda, MD 20892 USA
[16] NIH, Radiol Imaging Sci, Bldg 10, Bethesda, MD 20892 USA
基金
美国国家卫生研究院;
关键词
PROSTATE-CANCER DETECTION; JEFFREY C. WEINREB; JELLE O. BARENTSZ; DATA SYSTEM 2015; PETER L. CHOYKE; LOCALIZATION; MPMRI;
D O I
10.1148/radiol.2017161316
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Purpose: To validate the dominant pulse sequence paradigm and limited role of dynamic contrast material-enhanced magnetic resonance (MR) imaging in the Prostate Imaging Reporting and Data System (PI-RADS) version 2 for prostate multiparametric MR imaging by using data from a multireader study. Materials and Methods: This HIPAA-compliant retrospective interpretation of prospectively acquired data was approved by the local ethics committee. Patients were treatment-naive with endorectal coil 3-T multiparametric MR imaging. A total of 163 patients were evaluated, 110 with prostatectomy after multiparametric MR imaging and 53 with negative multiparametric MR imaging and systematic biopsy findings. Nine radiologists participated in this study and interpreted images in 58 patients, on average (range, 56-60 patients). Lesions were detected with PI-RADS version 2 and were compared with whole-mount prostatectomy findings. Probability of cancer detection for overall, T2-weighted, and diffusion-weighted (DW) imaging PI-RADS scores was calculated in the peripheral zone (PZ) and transition zone (TZ) by using generalized estimating equations. To determine dominant pulse sequence and benefit of dynamic contrast-enhanced (DCE) imaging, odds ratios (ORs) were calculated as the ratio of odds of cancer of two consecutive scores by logistic regression. Results: A total of 654 lesions (420 in the PZ) were detected. The probability of cancer detection for PI-RADS category 2, 3, 4, and 5 lesions was 15.7%, 33.1%, 70.5%, and 90.7%, respectively. DW imaging outperformed T2-weighted imaging in the PZ (OR, 3.49 vs 2.45; P = .008). T2-weighted imaging performed better but did not clearly outperform DW imaging in the TZ (OR, 4.79 vs 3.77; P = .494). Lesions classified as PI-RADS category 3 at DW MR imaging and as positive at DCE imaging in the PZ showed a higher probability of cancer detection than did DCE-negative PI-RADS category 3 lesions (67.8% vs 40.0%, P = .02). The addition of DCE imaging to DW imaging in the PZ was beneficial (OR, 2.0; P = .027), with an increase in the probability of cancer detection of 15.7%, 16.0%, and 9.2% for PI-RADS category 2, 3, and 4 lesions, respectively. Conclusion: DW imaging outperforms T2-weighted imaging in the PZ; T2-weighted imaging did not show a significant difference when compared with DW imaging in the TZ by PI-RADS version 2 criteria. The addition of DCE imaging to DW imaging scores in the PZ yields meaningful improvements in probability of cancer detection. (C) RSNA, 2017
引用
收藏
页码:859 / 869
页数:11
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