Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Department of Radiology, Huaian Hospital of Huaian City, Huaian, China.
Abdom Radiol (NY). 2020 Dec;45(12):4142-4149. doi: 10.1007/s00261-020-02724-y. Epub 2020 Sep 9.
The studies comparing the versions 2 vs. 2.1 of the Prostate Imaging Reporting and Data System (PI-RADS) are rare. This study aimed to evaluate whether PI-RADS version 2.1 is superior in detecting transition zone prostate cancer in comparison with PI-RADS version 2.
This was a diagnostic study of patients with prostate diseases who visited the Urology Department of The Second Affiliated Hospital of Soochow University and underwent a magnetic resonance imaging (MRI) examination between 03-01-2016 and 10-31-2018. The images originally analyzed using PI-RADS version 2 were retrospectively re-analyzed and scored in 2019 according to the updated PI-RADS version 2.1. The kappa and receiver operating characteristic (ROC) curves were used.
For Reader 1, compared with PI-RADS version 2, version 2.1 had higher sensitivity (85% vs. 79%, P = 0.03), lower specificity (65% vs. 83%, P < 0.001), and lower area under the curve (AUC) (0.749 vs. 0.809, P < 0.001). For Reader 2 (first attempt), compared with PI-RADS version 2, version 2.1 had lower specificity (67% vs. 91%, P < 0.001) and lower AUC (0.702 vs. 0.844, P < 0.001). For Reader 2 (second attempt), compared with PI-RADS version 2, version 2.1 had higher sensitivity (88% vs. 78%, P < 0.001) and lower specificity (77% vs. 91%, P < 0.001). The kappa between the two attempts for Reader 2 was 0.321.
These results suggest that PI-RADS version 2.1 might improve the detection of prostate cancers in the transition zone compared with PI-RADS version 2 but that it might results in higher numbers of biopsies because of lower specificity.
比较前列腺影像报告和数据系统（PI-RADS）版本 2 与 2.1 的研究很少。本研究旨在评估 PI-RADS 版本 2.1 是否优于 PI-RADS 版本 2，在检测移行区前列腺癌方面更具优势。
这是一项对 2016 年 3 月 1 日至 2018 年 10 月 31 日期间在苏州大学附属第二医院泌尿科就诊并接受磁共振成像（MRI）检查的前列腺疾病患者进行的诊断研究。对最初使用 PI-RADS 版本 2 分析的图像进行回顾性重新分析，并于 2019 年根据更新的 PI-RADS 版本 2.1 进行重新评分。使用kappa 和受试者工作特征（ROC）曲线。
对于读者 1，与 PI-RADS 版本 2 相比，PI-RADS 版本 2.1 具有更高的灵敏度（85%比 79%，P=0.03），更低的特异性（65%比 83%，P<0.001）和更低的曲线下面积（AUC）（0.749 比 0.809，P<0.001）。对于读者 2（首次尝试），与 PI-RADS 版本 2 相比，PI-RADS 版本 2.1 的特异性较低（67%比 91%，P<0.001）和 AUC 较低（0.702 比 0.844，P<0.001）。对于读者 2（第二次尝试），与 PI-RADS 版本 2 相比，PI-RADS 版本 2.1 的灵敏度较高（88%比 78%，P<0.001），特异性较低（77%比 91%，P<0.001）。读者 2 两次尝试之间的 kappa 值为 0.321。
这些结果表明，PI-RADS 版本 2.1 可能比 PI-RADS 版本 2 更能提高移行区前列腺癌的检出率，但特异性较低可能导致活检数量增加。
