Kwon Mi-Ri, Kim Chan Kyo, Kim Jae-Hun
1 Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
2 Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul, Korea.
Br J Radiol. 2017 Nov;90(1079):20170438. doi: 10.1259/bjr.20170438. Epub 2017 Oct 6.
To investigate the variability of diffusion-weighted imaging (DWI) interpretation of Prostate Imaging Reporting and Data System (PI-RADS) version 2 (v2) in evaluating prostate cancer (PCa).
154 patients with PCa underwent multiparametric 3T MRI, followed by radical prostatectomy. DWI with different b values (b = 0, 100, 1000 and 1500 s mm) was obtained. Using the PI-RADS v2, two radiologists independently scored suspicious lesions in each patient and compared DWI of b = 1000 (DWI) with 1500 (DWI) s mm.
On DWI and DWI, the intermethod and interobserver agreements of DWI scores were excellent in all patients (κ ≥ 0.873). In each peripheral zone and transition zone DWI scores, both observers showed excellent intermethod agreement between DWI and DWI (κ ≥ 0.897), and interobserver agreement for DWI and DWI was good to excellent (κ ≥ 0.796). For estimating clinically significant cancer, the area under receiver operating characteristics curves of DWI and DWI were 0.710 and 0.724 for observer 1 (p = 0.11), and 0.649 and 0.656 for observer 2 (p = 0.12), respectively.
The PI-RADS v2 scoring at 3T shows excellent agreement between DWI and DWI in evaluating PCa, with excellent inter-observer agreement. Advance in knowledge: DWI using b = 1000 s mm instead of b = 1500 s mm reduces examination time or image distortion, with improved the signal-to-noise ratio.
探讨前列腺影像报告和数据系统（PI-RADS）第2版（v2）中扩散加权成像（DWI）在评估前列腺癌（PCa）时的变异性。
154例PCa患者接受多参数3T磁共振成像（MRI）检查，随后进行根治性前列腺切除术。获取不同b值（b = 0、100、1000和1500 s/mm²）的DWI图像。两名放射科医生根据PI-RADS v2独立对每位患者的可疑病变进行评分，并比较b = 1000 s/mm²（DWI）和b = 1500 s/mm²（DWI）的DWI图像。
在DWI和DWI图像上，所有患者DWI评分的方法间和观察者间一致性均极佳（κ≥0.873）。在每个外周带和移行带的DWI评分中，两名观察者均显示DWI和DWI之间的方法间一致性极佳（κ≥0.897），DWI和DWI的观察者间一致性良好至极佳（κ≥0.796）。对于评估临床显著性癌症，观察者1的DWI和DWI的受试者工作特征曲线下面积分别为0.710和0.724（p = 0.11），观察者2的分别为0.649和0.656（p = 0.12）。
3T下的PI-RADS v2评分在评估PCa时，DWI和DWI之间显示出极佳的一致性，观察者间一致性也极佳。知识进展：使用b = 1000 s/mm²而非b = 1500 s/mm²的DWI可减少检查时间或图像失真，并提高信噪比。
