Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK; Division of Surgery & Interventional Science, University College London, London, UK.
Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK.
Eur Urol Oncol. 2020 Oct;3(5):615-619. doi: 10.1016/j.euo.2020.06.007. Epub 2020 Jul 6.
The PRECISION trial was a multicentre randomised study that demonstrated that multiparametric magnetic resonance imaging (mpMRI)-targeted biopsy is superior to standard transrectal ultrasound-guided biopsy for the detection of prostate cancer. The outcomes of studies reporting mpMRI-targeted biopsies are dependent on the quality of the mpMRI but there are currently no scoring systems available for evaluating this. We introduced a novel scoring system, the Prostate Imaging Quality (PI-QUAL) score, to assess the quality of scans in the PRECISION trial. PI-QUAL is a score on a Likert scale from 1 to 5, where 1 means that no mpMRI sequences are of diagnostic quality and 5 implies that each sequence is independently of optimal diagnostic quality. Fifty-eight out of 252 (23%) mpMRI scans chosen at random from each of the 22 centres in this trial were evaluated by two experienced radiologists from the coordinating trial centre, in consensus, blinded to pathology results. Overall, the mpMRI quality in the centres participating in PRECISION was good. MpMRI quality was of sufficient diagnostic quality (PI-QUAL ≥3) for 55 scans (95%) and of good or optimal diagnostic quality (PI-QUAL ≥4) for 35 scans (60%). Fifty-five out of 58 (95%) scans were of diagnostic quality for T2WI, followed by DWI (46/58 scans; 79%), and DCE (38/58 scans; 66%). Further validation of this scoring system is warranted. PATIENT SUMMARY: In this study we developed a scoring system (PI-QUAL) to assess the quality of multiparametric magnetic resonance imaging (mpMRI) in prostate cancer detection. We used scans from 22 centres that participated in the PRECISION trial. Although there was room for improvement in images that used intravenous contrast, we found that mpMRI in the PRECISION trial was of sufficient diagnostic quality (PI-QUAL score ≥3) for 95% of the scans.
PRECISION 试验是一项多中心随机研究，表明多参数磁共振成像（mpMRI）靶向活检优于标准经直肠超声引导活检，可提高前列腺癌的检出率。报道 mpMRI 靶向活检结果的研究取决于 mpMRI 的质量，但目前尚无评估该质量的评分系统。我们引入了一种新的评分系统——前列腺成像质量（PI-QUAL）评分，用于评估 PRECISION 试验中的扫描质量。PI-QUAL 评分采用 1 到 5 的李克特量表，其中 1 表示没有任何 mpMRI 序列具有诊断质量，5 表示每个序列均具有独立的最佳诊断质量。在该试验的 22 个中心中，每个中心随机选择 252 次 mpMRI 扫描中的 58 次，由来自协调试验中心的两位有经验的放射科医生进行评估，评估时两位医生彼此独立，对病理结果不知情。总体而言，参与 PRECISION 试验的中心的 mpMRI 质量良好。55 次扫描（95%）的 mpMRI 质量具有足够的诊断质量（PI-QUAL≥3），35 次扫描（60%）的 mpMRI 质量为良好或最佳诊断质量（PI-QUAL≥4）。58 次扫描中（95%），T2WI 的诊断质量为 55 次，其次是 DWI（46/58 次；79%）和 DCE（38/58 次；66%）。需要进一步验证该评分系统。患者总结：在这项研究中，我们开发了一种评分系统（PI-QUAL），用于评估前列腺癌检测中多参数磁共振成像（mpMRI）的质量。我们使用了来自参与 PRECISION 试验的 22 个中心的扫描。虽然静脉注射造影剂的图像仍有改进空间，但我们发现 PRECISION 试验中的 mpMRI 有 95%的扫描具有足够的诊断质量（PI-QUAL 评分≥3）。
