Department of Radiology, University Medical Center Groningen, Hanzeplein 1, 9700 CC, Groningen, The Netherlands.
Department of Urology, University Medical Center Groningen, Hanzeplein 1, 9700 CC, Groningen, The Netherlands.
Abdom Radiol (NY). 2019 Mar;44(3):1044-1051. doi: 10.1007/s00261-019-01919-2.
To investigate the effect of reader experience and zonal location on the occurrence of false positives (FPs) in PIRADS (V2) 3, 4, and 5 lesions on multiparametric (MP)-MRI of the prostate.
This retrospective study included 139 patients who had consecutively undergone an MP-MRI of the prostate in combination with a transrectal ultrasound MRI fusion-guided biopsy between 2014 and 2017. MRI exams were prospectively read by a group of inexperienced radiologists (cohort 1; 54 patients) and an experienced radiologist (cohort 2; 85 patients). Multivariable logistic regression analysis was performed to determine the association of experience of the radiologist and zonal location with a FP reading. FP rates were compared between readings by inexperienced and experienced radiologists according to zonal location, using Chi-square (χ) tests.
A total of 168 lesions in 139 patients were detected. Median patient age was 68 years (Interquartile range (IQR) 62.5-73), and median PSA was 10.9 ng/mL (IQR 7.6-15.9) for the entire patient cohort. According to multivariable logistic regression, inexperience of the radiologist was significantly (P = 0.044, odds ratio 1.927, 95% confidence interval [CI] 1.017-3.651) and independently associated with a FP reading, while zonal location was not (P = 0.202, odds ratio 1.444, 95% CI 0.820-2.539). In the transition zone (TZ), the FP rate of the inexperienced radiologists 59% (17/29) was significantly higher (χP = 0.033) than that of the experienced radiologist 33% (13/40).
Inexperience of the radiologist is significantly and independently associated with a FP reading, while zonal location is not. Inexperienced radiologists have a significantly higher FP rate in the TZ.
探讨读者经验和区域位置对前列腺多参数（MP）MRI 的 PIRADS（V2）3、4 和 5 级病变中假阳性（FP）发生的影响。
本回顾性研究纳入了 2014 年至 2017 年间连续进行 MP-MRI 前列腺检查并结合经直肠超声 MRI 融合引导活检的 139 例患者。前瞻性地由一组无经验的放射科医生（队列 1；54 例患者）和有经验的放射科医生（队列 2；85 例患者）阅读 MRI 检查结果。采用多变量逻辑回归分析确定放射科医生经验和区域位置与 FP 阅读之间的关联。根据区域位置，使用卡方（χ）检验比较无经验和有经验的放射科医生阅读之间的 FP 率。
在 139 例患者中，共发现 168 个病灶。整个患者队列的中位年龄为 68 岁（四分位距 62.5-73），中位 PSA 为 10.9ng/ml（四分位距 7.6-15.9）。根据多变量逻辑回归分析，放射科医生经验不足与 FP 阅读显著相关（P=0.044，优势比 1.927，95%置信区间[CI]1.017-3.651），而区域位置无显著相关（P=0.202，优势比 1.444，95% CI 0.820-2.539）。在移行区（TZ），无经验放射科医生的 FP 率为 59%（17/29），明显高于有经验放射科医生的 33%（13/40）（χP=0.033）。
放射科医生经验不足与 FP 阅读显著相关，而区域位置无显著相关。无经验的放射科医生在 TZ 中的 FP 率明显更高。
