PI-RADS v2与PI-RADS v1的直接比较。
Head-to-head comparison of PI-RADS v2 and PI-RADS v1.
作者信息
Polanec Stephan, Helbich Thomas H, Bickel Hubert, Pinker-Domenig Katja, Georg Dietmar, Shariat Shahrokh F, Aulitzky Wolfgang, Susani Martin, Baltzer Pascal A
机构信息
Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, A-1090 Wien, Austria.
Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, A-1090 Wien, Austria; Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University Vienna (AKH), Waehringer-Guertel 18-20, A-1090 Wien, Austria.
出版信息
Eur J Radiol. 2016 Jun;85(6):1125-31. doi: 10.1016/j.ejrad.2016.03.025. Epub 2016 Mar 29.
PURPOSE
To compare the reproducibility and diagnostic performance of PI-RADS version 2 (v2) and version 1 (v1) for the diagnosis of prostate cancer (PCa) on multiparametric MRI.
METHODS
This IRB-approved retrospective study included 65 consecutive biopsy-naïve or biopsy-negative patients suspicious for PCa (mean age: 65 years, mean PSA: 10.8ng/ml) who were undergoing MR-guided biopsy after multiparametric 3T prostate MRI (T2w, DWI, DCE). Two independent readers (R1; R2) scored the prostate lesions according to the v2 score and the v1 sum score. Diagnostic measures (sensitivity, specificity, and area under the ROC-curve) were compared for all cases and stratified by location (transitional zone, TZ, peripheral zone, PZ). Inter-reader agreement was assessed by kappa statistics.
RESULTS
Inter reader agreement for v2 and v1 was substantial to almost perfect (kappa v2: 0.71, v1: 0.81). Overall, sensitivity between both readers and methods did not differ (p>0.05). Overall specificity was higher using v1 compared to v2 (R1: p=0.0078, R2: p=0.0313) In the TZ, v2 showed a higher AUC (0.81-0.84) compared to v1 (AUC 0.77-0.78). Here, the sensitivity of v2 (87.5-100%) was higher than that of v1 (75%) while v2 specificity (50%-56.3%) was lower than that of v1 (68.8-75%). In the PZ, AUCs were higher using v1 (AUC 0.82-0.83) compared to v2 (AUC 0.61-0.63). The specificity for v1 was higher (43.8-62.3%) than that for v2 (12.5-18.8%) while both v2 and v1 achieved 100% sensitivity.
CONCLUSION
PI-RADS v2 and v1 inter-reader agreement is excellent, but their diagnostic performance differs. While v2 appears to be the preferable method for the evaluation of TZ lesions, v1 performs better in the PZ.
目的
比较PI-RADS第2版（v2）和第1版（v1）在多参数MRI上诊断前列腺癌（PCa）的可重复性和诊断性能。
方法
这项经机构审查委员会批准的回顾性研究纳入了65例连续的初诊未活检或活检阴性但怀疑患有PCa的患者（平均年龄：65岁，平均PSA：10.8ng/ml），这些患者在接受多参数3T前列腺MRI（T2w、DWI、DCE）检查后接受了MR引导下活检。两名独立阅片者（R1；R2）根据v2评分和v1总分对前列腺病变进行评分。比较所有病例的诊断指标（敏感性、特异性和ROC曲线下面积），并按病变位置（移行区，TZ；外周区，PZ）进行分层。阅片者间的一致性通过kappa统计量进行评估。
结果
v2和v1阅片者间的一致性为高度一致至几乎完全一致（v2的kappa值：0.71，v1的kappa值：0.81）。总体而言，两位阅片者以及两种方法之间的敏感性无差异（p>0.05）。与v2相比，v1的总体特异性更高（R1：p = 0.0078，R2：p = 0.0313）。在TZ中，v2的AUC（0.81 - 0.84）高于v1（AUC 0.77 - 0.78）。在此处，v2的敏感性（87.5% - 100%）高于v1（75%），而v2的特异性（50% - 56.3%）低于v1（68.8% - 75%）。在PZ中，v1的AUC（0.82 - 0.83）高于v2（AUC 0.61 - 0.63）。v1的特异性更高（43.8% - 62.3%），高于v2（12.5% - 18.8%）；而v2和v1的敏感性均达到100%。
结论
PI-RADS v2和v1阅片者间的一致性良好，但它们的诊断性能有所不同。虽然v2似乎是评估TZ病变的更优方法，但v1在PZ中的表现更好。
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