Schimmöller L, Quentin M, Arsov C, Lanzman R S, Hiester A, Rabenalt R, Antoch G, Albers P, Blondin D
Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany.
Eur Radiol. 2013 Nov;23(11):3185-90. doi: 10.1007/s00330-013-2922-y. Epub 2013 Jun 12.
The recent European Society of Urogenital Radiology (ESUR) guidelines for evaluation and reporting of prostate multiparametric magnetic resonance imaging (mp-MRI) include the Prostate Imaging Reporting and Data System (PI-RADS). The aim of this study was to investigate the inter-reader agreement of this scoring system.
One hundred and sixty-four lesions in 67 consecutive patients with elevated prostate-specific antigen and previously negative trans-rectal ultrasound (TRUS)-guided biopsy were scored retrospectively by three blinded readers using PI-RADS. Mp-MRI was performed at 3 T using T2-weighted, diffusion-weighted and dynamic contrast-enhanced imagings (T2WI, DWI, DCE-MRI). Histology of all lesions was obtained by in-bore MRI-guided biopsy. Cohen's kappa statistics were calculated for all readers.
Inter-reader agreement for all lesions was good to moderate (T2WI, κ = 0.55; DWI, κ = 0.64; DCE-MRI, κ = 0.65). For tumour lesions it was good (T2WI, κ = 0.66; DWI, κ = 0.80; DCE-MRI, κ = 0.63) and for benign lesions moderate to good (T2WI, κ = 0.46; DWI, κ = 0.52; DCE-MRI, κ = 0.67). Using an overall PI-RADS score with a threshold of ≥10, we achieved a sensitivity of 85.7 %, and negative predictive value of 90.1 % for biopsied lesions.
PI-RADS score shows good to moderate inter-reader agreement and enables standardised evaluation of prostate mp-MRI, with high sensitivity and negative predictive value.
• The European Society of Urogenital Radiology recently published guidelines for prostate MRI. • We have evaluated inter-reader agreement of ESUR scoring for multiparametric prostate MRI. • PI-RADS shows good to moderate inter-reader agreement and is clinically applicable. • PI-RADS achieves in our series high sensitivity and negative predictive value for biopsied lesions. • PI-RADS can be used as standardised scoring system in prostate cancer detection.
欧洲泌尿生殖放射学会（ESUR）近期发布的前列腺多参数磁共振成像（mp-MRI）评估与报告指南纳入了前列腺影像报告和数据系统（PI-RADS）。本研究旨在调查该评分系统在不同阅片者之间的一致性。
对67例前列腺特异性抗原升高且经直肠超声（TRUS）引导下活检先前结果为阴性的连续患者的164个病灶，由三名不知情的阅片者采用PI-RADS进行回顾性评分。mp-MRI在3T条件下进行，采用T2加权、扩散加权和动态对比增强成像（T2WI、DWI、DCE-MRI）。所有病灶的组织学结果通过磁共振引导下活检获得。计算所有阅片者的Cohen's kappa统计量。
所有病灶在不同阅片者之间的一致性为中等至良好（T2WI，κ = 0.55；DWI，κ = 0.64；DCE-MRI，κ = 0.65）。对于肿瘤性病灶，一致性良好（T2WI，κ = 0.66；DWI，κ = 0.80；DCE-MRI，κ = 0.63），对于良性病灶，一致性为中等至良好（T2WI，κ = 0.46；DWI，κ = 0.52；DCE-MRI，κ = 0.67）。使用总体PI-RADS评分阈值≥10时，活检病灶的敏感性为85.7%，阴性预测值为90.1%。
PI-RADS评分在不同阅片者之间的一致性为中等至良好，能够对前列腺mp-MRI进行标准化评估，具有高敏感性和阴性预测值。
• 欧洲泌尿生殖放射学会近期发布了前列腺MRI指南。• 我们评估了ESUR对多参数前列腺MRI评分在不同阅片者之间的一致性。• PI-RADS在不同阅片者之间的一致性为中等至良好，具有临床适用性。• 在我们的研究系列中，PI-RADS对活检病灶具有高敏感性和阴性预测值。• PI-RADS可作为前列腺癌检测的标准化评分系统。
