Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
Department of Library, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
Chin Med J (Engl). 2018 Jul 20;131(14):1666-1673. doi: 10.4103/0366-6999.235872.
One of the main aims of the updated Prostate Imaging Reporting and Data System Version 2 (PI-RADS v2) is to diminish variation in the interpretation and reporting of prostate imaging, especially among readers with varied experience levels. This study aimed to retrospectively analyze diagnostic consistency and accuracy for prostate disease among six radiologists with different experience levels from a single center and to evaluate the diagnostic performance of PI-RADS v2 scores in the detection of clinically significant prostate cancer (PCa).
From December 2014 to March 2016, 84 PCa patients and 99 benign prostatic shyperplasia patients who underwent 3.0T multiparametric magnetic resonance imaging before biopsy were included in our study. All patients received evaluation according to the PI-RADS v2 scale (1-5 scores) from six blinded readers (with 6 months and 2, 3, 4, 5, or 17 years of experience, respectively, the last reader was a reviewer/contributor for the PI-RADS v2). The correlation among the readers' scores and the Gleason score (GS) was determined with the Kendall test. Intra-/inter-observer agreement was evaluated using κ statistics, while receiver operating characteristic curve and area under the curve analyses were performed to evaluate the diagnostic performance of the scores.
Based on the PI-RADS v2, the median κ score and standard error among all possible pairs of readers were 0.506 and 0.043, respectively; the average correlation between the six readers' scores and the GS was positive, exhibiting weak-to-moderate strength (r = 0.391, P = 0.006). The AUC values of the six radiologists were 0.883, 0.924, 0.927, 0.932, 0.929, and 0.947, respectively.
The inter-reader agreement for the PI-RADS v2 among the six readers with different experience is weak to moderate. Different experience levels affect the interpretation of MRI images.
前列腺影像报告和数据系统更新版 2（PI-RADS v2）的主要目标之一是减少前列腺成像解释和报告中的差异，尤其是在经验水平不同的读者之间。本研究旨在回顾性分析来自单一中心的六位不同经验水平的放射科医生对前列腺疾病的诊断一致性和准确性，并评估 PI-RADS v2 评分在检测临床显著前列腺癌（PCa）中的诊断性能。
2014 年 12 月至 2016 年 3 月，我们纳入了 84 例 PCa 患者和 99 例良性前列腺增生患者，这些患者在活检前均接受了 3.0T 多参数磁共振成像检查。所有患者均接受了 PI-RADS v2 评分（1-5 分）评估，由六位盲法读者（经验分别为 6 个月、2 年、3 年、4 年、5 年和 17 年，最后一位读者是 PI-RADS v2 的评审员/贡献者）进行评估。使用 Kendall 检验确定读者评分与 Gleason 评分（GS）之间的相关性。使用κ统计量评估内部/观察者间一致性，同时进行受试者工作特征曲线和曲线下面积分析，以评估评分的诊断性能。
基于 PI-RADS v2，所有可能读者对之间的中位数κ评分和标准误差分别为 0.506 和 0.043；六位读者评分与 GS 之间的平均相关性为正，表现为弱至中度强度（r=0.391，P=0.006）。六位放射科医生的 AUC 值分别为 0.883、0.924、0.927、0.932、0.929 和 0.947。
六位不同经验水平的读者对 PI-RADS v2 的读者间一致性为弱至中度。不同的经验水平会影响对 MRI 图像的解释。
