Abstract
Simple SummaryThe newest Prostate Imaging Reporting and Data System (PI-RADS) version 2.1, was published in 2019. There are a few variations of the new standard, which will change prostate lesions’ classification rules. Our study aims to analyze the pattern change of lesion positron emission tomography (PET) standardized uptake values maximum (SUVmax) distribution under PI-RADS V2.1, compared with PI-RADS V2.0. Moreover, we studied the correlation between prostate-specific membrane antigen (PSMA) SUVmax and magnetic resonance imaging (MRI) PI-RADS. So far, there is no article reporting the effect of the newest PI-RADS on [68Ga]Ga-PSMA-11 PET/MRI. We did a thorough analysis, including two subgroups, peripheral zone, transitional zone, and 215 lesions. We analyzed the impact of each variation of PI-RADS one by one.Purpose: We aimed to evaluate the correlation between PSMA uptake and magnetic resonance imaging (MRI) PI-RADS of simultaneous [68Ga]Ga-PSMA-11 PET/MRI regarding PI-RADS version 2.0 and 2.1 respectively and compared the difference between these two versions. Materials and Methods: We retrospectively analyzed a total of forty-six patients with biopsy-proven prostate cancer who underwent simultaneous [68Ga]Ga-PSMA-11 PET/MRI. We classified the lesions regarding PI-RADS version 2.0 and 2.1, peripheral zone (PZ), and transitional zone (TZ), respectively. Based on regions of interest (ROI), standardized uptake values maximum (SUVmax), and corresponding lesion-to-background ratios (LBR) of SUVmax of each category, PI-RADS score 1 to 5, were measured. A comparison between PI-RADS version 2.0 and PI-RADS version 2.1 was performed. Results: A total of 215 focal prostate lesions were analyzed, including two subgroups, 125 TZ and 90 PZ. Data are reported as median and interquartile range (IQR). Regarding PI-RADS version 2.1, TZ SUVmax of each category were 1.5 (0.5, 1.9), 1.9 (0.8, 2.3), 3.3 (2.1, 4.6), 4.2 (3.1, 5.7), 7.3 (5.2, 9.7). PZ SUVmax of each category were 1.0 (0.8, 1.6), 2.5 (1.5, 3.2), 3.3 (1.9, 4.5), 4.3 (3.0, 5.4), 7.4 (5.0, 9.3). Regarding the inter-reader agreement of the overall PI-RADS assessment category, the kappa value was 0.723 for version 2.0 and 0.853 for version 2.1. Conclusion: Revisions of PI-RADS version 2.1 results in variations in lesions classification. Lesions with the PI-RADS category of 3, 4, and 5 present relatively higher intraprostatic PSMA uptake, while lesions with the PI-RADS category of 1 and 2 present relatively lower and similar uptake. Version 2.1 has higher inter-reader reproducibility than version 2.0.
Highlights
Prostate cancer (PCa) is a common malignant disease in the elderly male population [1], and a percentage of patients with early prostate cancer have metastatic disease
To sum up the above points, we evaluated the correlation between Prostate-specific membrane antigen (PSMA) uptake and magnetic resonance imaging (MRI) PI-RADS of the inter-reader agreement
We proved that PI-RADS version 2.1 has comparable performance in detecting prostate focal lesions compared with version 2.0
Summary
Prostate cancer (PCa) is a common malignant disease in the elderly male population [1], and a percentage of patients with early prostate cancer have metastatic disease. It is important to be able to determine tumor behavior as well as the diagnosis. Multiparametric magnetic resonance imaging (mpMRI) is a clinical imaging tool for detecting primary PCa and guiding the subsequent biopsy. MpMRI includes T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced MRI (DCE-MRI). Prostate cancer is a type of cancer that can be extremely heterogeneous. It is important to accurately evaluate and describe the imaging features of prostate cancer lesions. The American College of Radiology, European Radiology of Uroradiology, and AdMeTech Foundation jointly released the Prostate Imaging
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