Yang S, Zhang C Y, Zhang Y Y, Tan S X, Wei C G, Shen X H, Shen J K
Department of Imaging, Second Affiliated Hospital of Soochow University, Suzhou 215004, China.
Zhonghua Yi Xue Za Zhi. 2020 Dec 8;100(45):3609-3613. doi: 10.3760/cma.j.cn112137-20200506-01442.
To compare and analyze the diagnostic value of prostate imaging reporting and data system (PI-RADS) version 2.1 and version 2 for prostate transitional zone lesions. The imaging data of 159 patients with major prostate lesions located in the transitional zone collected by the Department of Radiology of the Second Affiliated Hospital of Suzhou University from January to December 2017 were retrospectively analyzed. Two radiologists used PI-RADS V2.1 and V2 scoring system respectively to perform diagnostic scores on the enrolled cases. The weighted Kappa test was used to evaluate the consistency of PI-RADS V2.1 and V2 scores between the two radiologists. The receiver operating characteristic (ROC) curve was used to evaluate and compare the diagnostic efficiency of two radiologists using two scoring systems for transitional zone prostate cancer (PCa) and clinically significant PCa (csPCa). The weighted Kappa values between the scores of all lesions, benign lesions, PCa lesions, and csPCa lesions by the two radiologists using PI-RADS V2.1 and V2 scoring systems were 0.754, 0.643, 0.734, 0.782 and 0.808, 0.738, 0.775, 0.826, respectively. The PI-RADS V2.1 scoring system had a better consistency. There were no statistically significant differences in sensitivity, specificity, area under the ROC curve (AUC) between the PI-RADS V2.1 and V2 scoring system for PCa and csPCa (all 0.05). However, in this set of data, the sensitivity and AUC value of PI-RADS V2.1 scoring system in diagnosing PCa and csPCa were higher than those of P-RADS V2. The diagnostic sensitivity of PI-RADS V2.1 and V2 for PCa were 86.7% and 80.0%, the diagnostic sensitivity for csPCa were 94.4% and 88.9%, the diagnostic AUC for PCa were 0.857 and 0.816, and the diagnostic AUC of csPCa were 0.917 and 0.886, respectively. The consistency of PI-RADS V2.1 in scoring prostate transitional zone lesions was better than PI-RADS V2. The diagnostic efficiency of PI-RADS V2.1 for transitional carcinoma was not lower than or slightly higher than PI-RADS V2.
比较分析前列腺影像报告和数据系统（PI-RADS）2.1版与2版对前列腺移行区病变的诊断价值。回顾性分析苏州大学附属第二医院放射科于2017年1月至12月收集的159例主要位于移行区的前列腺病变患者的影像资料。两名放射科医生分别使用PI-RADS V2.1和V2评分系统对纳入病例进行诊断评分。采用加权Kappa检验评估两名放射科医生PI-RADS V2.1和V2评分的一致性。采用受试者工作特征（ROC）曲线评估并比较两名放射科医生使用两种评分系统对前列腺移行区癌（PCa）和临床显著前列腺癌（csPCa）的诊断效能。两名放射科医生使用PI-RADS V2.1和V2评分系统对所有病变、良性病变、PCa病变和csPCa病变评分的加权Kappa值分别为0.754、0.643、0.734、0.782和0.808、0.738、0.775、0.826。PI-RADS V2.1评分系统一致性更好。PI-RADS V2.1和V2评分系统对PCa和csPCa的敏感性、特异性、ROC曲线下面积（AUC）差异均无统计学意义（均P>0.05）。然而，在这组数据中，PI-RADS V2.1评分系统诊断PCa和csPCa的敏感性和AUC值高于PI-RADS V2。PI-RADS V2.1和V2对PCa的诊断敏感性分别为86.7%和80.0%，对csPCa的诊断敏感性分别为94.4%和88.9%，对PCa的诊断AUC分别为0.857和0.816，对csPCa的诊断AUC分别为0.917和0.886。PI-RADS V2.1对前列腺移行区病变评分的一致性优于PI-RADS V2。PI-RADS V2.1对移行癌的诊断效能不低于或略高于PI-RADS V2。
