Multi-parametric MRI and PI-RADS (V1) scoring system: New inception in cancer prostate diagnosis to evaluate diagnostic performance of different score combinations

Abstract

ObjectivesEvaluating ESUR-proposed PI-RADS scoring system for prostate cancer detection using multi-parametric MRI and comparing diagnostic performances of single and combined scores. Methods76 prostatic lesions in 54 patients prospectively assessed using mpMRI. T2, DWI, DCE, MRS single, combined PI-RADS scores as well as PIRADS summed score for all four sequences were recorded and histopathologically correlated. Results61 out of 76 lesions were positive for cancer prostate. Peripheral zone lesions showed PI-RADS sum score was highest AUC for Pca detection (Az=0.923) while highest AUC for single score was for DCE score (0.921). Best combined score was for T2+DCE scores. Central gland lesions showed highest AUC of 0.953 for PI-RADS sum score, and combined T2+DWI score showed highest AUC of 0.969. Single score with statistically significant AUC was T2 score (Az=0.875). Sum score in both PZ lesions and CG lesions showed no false positive results with 100% specificity for scores above 12. ConclusionsPI-RADS scoring system and mpMRI have a promising role in Pca detection still using single score resulted in lower diagnostic accuracy which improved for combined scores. mpMRI results in CG showed controversies and need more evaluation in the future.