Diagnostic Performance of PI-RADS v2, Proposed Adjusted PI-RADS v2 and Biparametric Magnetic Resonance Imaging for Prostate Cancer Detection: A Preliminary Study.

Guan-Hui Cai,Yu-Rong Zeng,Yu-Jing Zeng,Qing-Yu Liu,Wen-Bo Chen,Qi-Hua Yang

doi:10.3390/curroncol28030169

Abstract

Purpose: To evaluate the diagnostic performance of PI-RADS v2, proposed adjustments to PI-RADS v2 (PA PI-RADS v2) and biparametric magnetic resonance imaging (MRI) for prostate cancer detection. Methods: A retrospective cohort of 224 patients with suspected prostate cancer was included from January 2016 to November 2018. All the patients underwent a multi-parametric MR scan before biopsy. Two radiologists independently evaluated the MR examinations using PI-RADS v2, PA PI-RADS v2, and a biparametric MRI protocol, respectively. Receiver operating characteristic (ROC) curves for the three different protocols were drawn. Results: In total, 90 out of 224 cases (40.18%) were pathologically diagnosed as prostate cancer. The area under the ROC curves (AUC) for diagnosing prostate cancers by biparametric MRI, PI-RADS v2, and PA PI-RADS v2 were 0.938, 0.935, and 0.934, respectively. For cancers in the peripheral zone (PZ), the diagnostic sensitivity was 97.1% for PI-RADS v2/PA PI-RADS v2 and 96.2% for biparametric MRI. Moreover, the specificity was 84.0% for biparametric MRI and 58.0% for PI-RADS v2/PA PI-RADS v2. For cancers in the transition zone (TZ), the diagnostic sensitivity was 93.4% for PA PI-RADS v2 and 88.2% for biparametric MRI/PI-RADS v2. Furthermore, the specificity was 95.4% for biparametric MRI/PI-RADS v2 and 78.0% for PA PI-RADS v2. Conclusions: The overall diagnostic performance of the three protocols showed minimal differences. For lesions assessed as being category 3 using the biparametric MRI protocol, PI-RADS v2, or PA PI-RADS v2, it was thought prostate cancer detection could be improved. Attention should be paid to false positive results when PI-RADS v2 or PA PI-RADS v2 are used.

Highlights

Prostate cancer is the second most frequent cancer in males worldwide [1], and its morbidity has risen over recent decades as the global population has continued to age and lifestyles have continued to change [2]
90 cases were diagnosed as clinically significant prostate cancer, whereas 52 were diagnosed
134 cases were diagnosed as benign lesions, whereas 25 were diagnosed peripheral zone (PZ) and 109 in transition zone (TZ) (Figures 2–4)

Summary

Introduction

Prostate cancer is the second most frequent cancer in males worldwide [1], and its morbidity has risen over recent decades as the global population has continued to age and lifestyles have continued to change [2]. In 2015, prostate cancer ranked sixth among all male malignant neoplasms in China [3]. The multi-parametric magnetic resonance imaging (mp-MRI) technique is the best and most accurate imaging method for prostate cancer detection, localization, and local staging [4,5]. As a product of international collaboration among the American College of Radiology, ESUR, and AdMetech Foundation, the second version of PI-RADS (PI-RADS v2) was released [6] and used as the guideline for prostate cancer MR diagnosis and reporting. The second version clarified the assessment criteria for different MRI sequences for different zones of the prostate.

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Discussion

Conclusion