Diagnostic performance and reproducibility of T2w based and diffusion weighted imaging (DWI) based PI-RADSv2 lexicon descriptors for prostate MRI

被引:23
作者
Benndorf, Matthias [1 ]
Hahn, Felix [2 ]
Kroenig, Malte [3 ]
Jilg, Cordula Annette [3 ]
Krauss, Tobias [1 ]
Langer, Mathias [1 ]
Dovi-Akue, Philippe [1 ]
机构
[1] Univ Freiburg, Dept Radiol, Med Ctr, Fac Med, Hugstetter Str 55, D-79106 Freiburg, Germany
[2] Johannes Gutenberg Univ Mainz, Univ Med Ctr, Dept Diagnost & Intervent Radiol, Langenbeckstr 1, D-55131 Mainz, Germany
[3] Univ Freiburg, Fac Med, Med Ctr, Dept Urol, Hugstetter Str 55, D-79106 Freiburg, Germany
关键词
PI-RADS; Prostate; Prostate MRI; Multiparametric; Diagnostic accuracy; PI-RADS V2; DATA SYSTEM; VERSION; CANCER;
D O I
10.1016/j.ejrad.2017.05.015
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 examine the diagnostic performa nce of PI-RADSv2 T2w and diffusion weighted imaging (DWI) based lexicon descriptors, inter-observer agreement for descriptor assignment and diagnostic accuracy of the PIRADSv2 assessment categories for multiparametric prostate MRI. Materials and methods: 176 lesions in 79 consecutive patients are analyzed, lesions are histopathologically verified by MRI-ultrasound fusion biopsy. All lesions are rated according to the PI-RADSv2 lexicon, descriptors for T2w and DWI sequences and resulting assessment categories are assigned by two independent blinded radiologists. We perform receiver-operating-characteristic analysis using the assessment categories. To analyze inter-observer agreement, we calculate weighted kappa values for assessment category assignment and unweighted kappa values for descriptor assignment. Results: PI-RADSv2 assessment categories yield an area under the curve of 0.76/0.74 (radiologist 1/radiologist 2), P> 0.05. Weighted kappa for agreement is 0.601 in the peripheral zone and 0.580 in the transition zone. We detect a difference in the cancer rate for PI-RADSv2 category 3 between peripheral zone (32%) and transition zone (12%), P< 0.05. We obtain moderate agreement at most for descriptor assignment with kappa values ranging from 0.082 (T2w shape in the transition zone) to 0.407 (T2w signal intensity in the peripheral zone) and 0.493 (ADC pattern in the peripheral zone). Our analysis corroborates typical descriptors for benign/malignant lesions, but also reveals insights into potential pitfalls-T2w wedge shaped lesions in the peripheral zone have a considerable cancer rate, despite being labelled category 2 in the lexicon. Conclusion: Agreement for descriptor assignment in the PI-RADSv2 lexicon is at most moderate in our study. Typical descriptors for benign and malignant lesions are validated, whereas the discriminatory power of some descriptors is challenged. The difference in the cancer rate for PI-RADSv2 category 3 between peripheral zone and transition zone should be considered when management recommendations are linked to assessment categories in the future.
引用
收藏
页码:9 / 15
页数:7
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