MP08-11 RADIOLOGIST EXPERIENCE LEVEL DOES NOT PREDICT THE ACCURACY OF PROSTATE MRI INTERPRETATION FOR CLINICALLY SIGNIFICANT PROSTATE CANCER: ARE CONSENSUS READS THE ANSWER?

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology I1 Apr 2017MP08-11 RADIOLOGIST EXPERIENCE LEVEL DOES NOT PREDICT THE ACCURACY OF PROSTATE MRI INTERPRETATION FOR CLINICALLY SIGNIFICANT PROSTATE CANCER: ARE CONSENSUS READS THE ANSWER? Eric Kim, Joel Vetter, Anup Shetty, Kathryn Fowler, Aaron Mintz, Cary Siegel, Gerald Andriole, and Robert Grubb III Eric KimEric Kim More articles by this author , Joel VetterJoel Vetter More articles by this author , Anup ShettyAnup Shetty More articles by this author , Kathryn FowlerKathryn Fowler More articles by this author , Aaron MintzAaron Mintz More articles by this author , Cary SiegelCary Siegel More articles by this author , Gerald AndrioleGerald Andriole More articles by this author , and Robert Grubb IIIRobert Grubb III More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.298AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To provide standardization as prostate MRI becomes increasingly utilized, the Prostate Imaging-Reporting and Data System (PIRADS) was developed and has been modified to its latest version (v2). Using biopsy outcome as the standard, we examined the predictive accuracy of a PIRADS 4 or 5 read for clinically significant (Gleason 7+) PCa in a blinded fashion. METHODS We reviewed our prospectively maintained database of consecutive men who underwent prostate MRI prior to biopsy between September 2014 and December 2015. A proportionally representative sample (based on the original clinical PIRADS v2 interpretation) was selected for re-examination (n=32). The prostate MRIs for these patients were de-identified and were loaded by a blinded third party. Four radiologists of varying levels of experience independently interpreted all prostate MRI, blinded to all clinical information. An ″over-read″ was defined as a PIRADS 4 or 5 read with biopsy result of benign prostate or Gleason 6 PCa. An ″under-read″ was defined as a PIRADS 1-3 read with resulting biopsy result of Gleason 7+ PCa. RESULTS The distribution of accuracy is provided in Table 1. Accurate interpretation ranged from 56% (18/32) to 75% (24/32), and the differences among the radiologists were not significant (p=0.48). The improvement of accuracy with a ″majority read″, as defined by two or more accurate radiologists′ blinded interpretations, over the original clinical read trends toward significance (p=0.16). No clinical variable was predictive of an incorrect ″majority read″, including age, PSA, family history, use of 5-alpha reductase inhibitors, prostate volume, or previous biopsy history. CONCLUSIONS In a blinded assessment of radiologists at our institution, we find that the predictive accuracy of PIRADS 4 or 5 for clinically significant PCa varies among radiologists independent of experience level. A ″majority read″ performed better than the original clinical interpretation, suggesting that consensus interpretation of prostate MRI may improve predictive accuracy. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e95 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Eric Kim More articles by this author Joel Vetter More articles by this author Anup Shetty More articles by this author Kathryn Fowler More articles by this author Aaron Mintz More articles by this author Cary Siegel More articles by this author Gerald Andriole More articles by this author Robert Grubb III More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...