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Comparison of the Prostate Imaging Reporting and Data System (PI-RADS) version 1 and 2 in a cohort of 245 patients with histopathological reference and long-term follow-up

Pieter De Visschere (UGent) , Eva Pattyn (UGent) , Piet Ost (UGent) , Tom Claeys, Nicolaas Lumen (UGent) and Geert Villeirs (UGent)
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Abstract
Objective: To compare the performance of PI-RADSv2 with PI-RADSv1 in patients with elevated PSA before biopsy. Methods: 245 patients with elevated PSA underwent mpMRI before biopsy between May 2011 and December 2014 at 3.0 Tesla without endorectal coil. Patients underwent transrectal ultrasound-guided systematic 12-core biopsy followed by radical prostatectomy (N = 68), radiation therapy (N = 91) or clinical follow-up for at least two years (N = 86). All exams were scored on a per-patient basis according to PI-RADSv1 and PI-RADSv2. ClinsigPC was defined as Gleason score >= 7 (including 3+4 with prominent but not predominant Gleason 4 component), and/or tumour volume of >= 0.5cc, and/or tumour stage >= T3a. Results: In 144 patients (58.8%) a ClinsigPC was found within two years after mpMRI. The PI-RADSv1 and PI-RADSv2 overall assessment scores were significantly higher (P < 0.001) in patients with ClinsigPC as compared to patients without ClinsigPC. ROC analysis showed an area under the curve of 0.82 (CI 0.76-0.87) for PI-RADSv1 and 0.79 (CI 0.73-0.85) for PI-RADSv2 (P: NS). A threshold score of 3 exhibited sensitivities of 88.2% and 79.2% (P = 0.001) and specificities of 64.4% and 67.3% (P: NS) with PI-RADSv1 and PI-RADSv2, respectively. Conclusions: The mpMRI scoring systems PI-RADSv1 and PI-RADSv2 yield similar accuracy to detect ClinsigPC in patients with elevated PSA, although clinicians should be aware that when an overall assessment score of 3 is used as a threshold for a positive mpMRI, PI-RADSv2 has lower sensitivity than PI-RADSv1. Nevertheless, PI-RADSv2 is preferable over PI-RADSv1 because it has the advantage of providing well-defined instructions on how to determine the overall assessment category.
Keywords
Prostate neoplasms, Magnetic Resonance Imaging, Diffusion Weighted Imaging, MR spectroscopic imaging, Prostate cancer, SCORING SYSTEM, MULTIPARAMETRIC MRI, REFERENCE-STANDARD, CANCER, VALIDATION, BIOPSY, AGREEMENT, DIAGNOSIS, ACCURACY

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Chicago
De Visschere, Pieter, Eva Pattyn, Piet Ost, Tom Claeys, Nicolaas Lumen, and Geert Villeirs. 2016. “Comparison of the Prostate Imaging Reporting and Data System (PI-RADS) Version 1 and 2 in a Cohort of 245 Patients with Histopathological Reference and Long-term Follow-up.” Journal of the Belgian Society of Radiology 100 (1).
APA
De Visschere, P., Pattyn, E., Ost, P., Claeys, T., Lumen, N., & Villeirs, G. (2016). Comparison of the Prostate Imaging Reporting and Data System (PI-RADS) version 1 and 2 in a cohort of 245 patients with histopathological reference and long-term follow-up. JOURNAL OF THE BELGIAN SOCIETY OF RADIOLOGY, 100(1).
Vancouver
1.
De Visschere P, Pattyn E, Ost P, Claeys T, Lumen N, Villeirs G. Comparison of the Prostate Imaging Reporting and Data System (PI-RADS) version 1 and 2 in a cohort of 245 patients with histopathological reference and long-term follow-up. JOURNAL OF THE BELGIAN SOCIETY OF RADIOLOGY. 2016;100(1).
MLA
De Visschere, Pieter et al. “Comparison of the Prostate Imaging Reporting and Data System (PI-RADS) Version 1 and 2 in a Cohort of 245 Patients with Histopathological Reference and Long-term Follow-up.” JOURNAL OF THE BELGIAN SOCIETY OF RADIOLOGY 100.1 (2016): n. pag. Print.
@article{8167713,
  abstract     = {Objective: To compare the performance of PI-RADSv2 with PI-RADSv1 in patients with elevated PSA before biopsy. 
Methods: 245 patients with elevated PSA underwent mpMRI before biopsy between May 2011 and December 2014 at 3.0 Tesla without endorectal coil. Patients underwent transrectal ultrasound-guided systematic 12-core biopsy followed by radical prostatectomy (N = 68), radiation therapy (N = 91) or clinical follow-up for at least two years (N = 86). All exams were scored on a per-patient basis according to PI-RADSv1 and PI-RADSv2. ClinsigPC was defined as Gleason score >= 7 (including 3+4 with prominent but not predominant Gleason 4 component), and/or tumour volume of >= 0.5cc, and/or tumour stage >= T3a. 
Results: In 144 patients (58.8%) a ClinsigPC was found within two years after mpMRI. The PI-RADSv1 and PI-RADSv2 overall assessment scores were significantly higher (P < 0.001) in patients with ClinsigPC as compared to patients without ClinsigPC. ROC analysis showed an area under the curve of 0.82 (CI 0.76-0.87) for PI-RADSv1 and 0.79 (CI 0.73-0.85) for PI-RADSv2 (P: NS). A threshold score of 3 exhibited sensitivities of 88.2% and 79.2% (P = 0.001) and specificities of 64.4% and 67.3% (P: NS) with PI-RADSv1 and PI-RADSv2, respectively. 
Conclusions: The mpMRI scoring systems PI-RADSv1 and PI-RADSv2 yield similar accuracy to detect ClinsigPC in patients with elevated PSA, although clinicians should be aware that when an overall assessment score of 3 is used as a threshold for a positive mpMRI, PI-RADSv2 has lower sensitivity than PI-RADSv1. Nevertheless, PI-RADSv2 is preferable over PI-RADSv1 because it has the advantage of providing well-defined instructions on how to determine the overall assessment category.},
  articleno    = {108},
  author       = {De Visschere, Pieter and Pattyn, Eva and Ost, Piet and Claeys, Tom and Lumen, Nicolaas and Villeirs, Geert},
  issn         = {1780-2393},
  journal      = {JOURNAL OF THE BELGIAN SOCIETY OF RADIOLOGY},
  keywords     = {Prostate neoplasms,Magnetic Resonance Imaging,Diffusion Weighted Imaging,MR spectroscopic imaging,Prostate cancer,SCORING SYSTEM,MULTIPARAMETRIC MRI,REFERENCE-STANDARD,CANCER,VALIDATION,BIOPSY,AGREEMENT,DIAGNOSIS,ACCURACY},
  language     = {eng},
  number       = {1},
  pages        = {10},
  title        = {Comparison of the Prostate Imaging Reporting and Data System (PI-RADS) version 1 and 2 in a cohort of 245 patients with histopathological reference and long-term follow-up},
  url          = {http://dx.doi.org/10.5334/jbr-btr.1147},
  volume       = {100},
  year         = {2016},
}

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