前列腺 MRI 质量：PI-RADS 标准是否足够？
Quality of Prostate MRI: Is the PI-RADS Standard Sufficient?
机构信息
Molecular Imaging Program, National Cancer Institute, NIH, Bethesda, MD, USA; Loma Linda University School of Medicine, Loma Linda, CA, USA.
Division of Cancer Treatment and Diagnosis: Biometric Research Program, National Cancer Institute, NIH, Bethesda, MD, USA.
出版信息
Acad Radiol. 2021 Feb;28(2):199-207. doi: 10.1016/j.acra.2020.01.031. Epub 2020 Mar 4.
RATIONALE AND OBJECTIVE
The Prostate Imaging Reporting and Data System version 2 (PI-RADSv2) published a set of minimum technical standards (MTS) to improve image quality and reduce variability in multiparametric prostate MRI. The effect of PIRADSv2 MTS on image quality has not been validated. We aimed to determine whether adherence to PI-RADSv2 MTS improves study adequacy and perceived quality.
MATERIALS AND METHODS
Sixty-two prostate MRI examinations including T2 weighted (T2W) and diffusion weighted image (DWI) consecutively referred to our center from 62 different institutions within a 12-month period (September 2017 to September 2018) were included. Six readers assessed images as adequate or inadequate for use in PCa detection and a numerical image quality ranking was given using a 1-5 scale. The PI-RADSv2 MTS were synthesized into sets of seven and 10 rules for T2W and DWI, respectively. Image adherence was assessed using Digital Imaging and Communications in Medicine (DICOM) metadata. Statistical analysis of survey results and image adherence was performed based on reader quality scoring (Kendall Rank tau-b) and reader adequate scoring (Wilcoxon test for association) for T2 and DWI quality assessment.
RESULTS
Out of 62 images, 52 (83%) T2W and 38 (61%) DWIs were rated to be adequate by a majority of readers. Reader adequacy scores showed no significant association with adherence to PI-RADSv2. There was a weak (tau-b = 0.22) but significant (p value = 0.01) correlation between adherence to PIRADSv2 MTS and image quality for T2W. Studies following all PI-RADSv2 T2W rules achieved a higher median average quality score (3.58 for 7/7 vs. 3.0 for <7/7, p = 0.012). No statistical relationship with PI-RADSv2 MTS adherence and DWI quality was found.
CONCLUSION
Among 62 sites performing prostate MRI, few were considered of high quality, but the majority were considered adequate. DWI showed considerably lower rates of adequate studies in the sample. Adherence to PI-RADSv2 MTS did not increase the likelihood of having a qualitatively adequate T2W or DWI.
背景与目的
前列腺影像报告和数据系统第 2 版（PI-RADSv2）发布了一套最低技术标准（MTS），以提高多参数前列腺 MRI 的图像质量并降低变异性。PI-RADSv2 MTS 对图像质量的影响尚未得到验证。我们旨在确定是否遵守 PI-RADSv2 MTS 可以提高研究的充分性和感知质量。
材料与方法
在 12 个月的时间内（2017 年 9 月至 2018 年 9 月），我们从 62 个不同机构连续纳入了 62 例前列腺 MRI 检查，包括 T2 加权（T2W）和弥散加权成像（DWI）。六位读者评估了图像是否可用于前列腺癌检测，如果可以，则使用 1-5 分的数字图像质量评分进行评分。PI-RADSv2 MTS 分别综合为 T2W 和 DWI 的七组和十组规则。使用数字成像和通信医学（DICOM）元数据评估图像依从性。基于读者质量评分（Kendall 秩 tau-b）和读者充分评分（用于关联的 Wilcoxon 检验）对 T2 和 DWI 质量评估的调查结果和图像依从性进行了统计分析。
结果
在 62 幅图像中，有 52 幅（83%）T2W 和 38 幅（61%）DWI 得到了大多数读者的充分评价。读者充分性评分与 PI-RADSv2 的依从性没有显著关联。PI-RADSv2 MTS 的依从性与 T2W 的图像质量之间存在微弱的（tau-b=0.22）但具有统计学意义的相关性（p 值=0.01）。遵循所有 PI-RADSv2 T2W 规则的研究获得了更高的平均质量评分（7/7 为 3.58 分，<7/7 为 3.0 分，p=0.012）。未发现 PI-RADSv2 MTS 依从性与 DWI 质量之间存在统计学关系。
结论
在 62 个进行前列腺 MRI 的地点中，很少有被认为是高质量的，但大多数被认为是充分的。在样本中，DWI 的充分研究率较低。PI-RADSv2 MTS 的依从性并未增加 T2W 或 DWI 的定性充分性的可能性。
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