The role of different PI-RADS versions in prostate multiparametric magnetic resonance tomography assessment.

Paulius Aliukonis,Tadas Letauta,Simona Letautienė,Rūta Briedienė,Ieva Naruševičiūtė

doi:10.6001/actamedica.v24i1.3462

Abstract

Background. Standardised Prostate Imaging Reporting and Data System (PI-RADS) guidelines for the assessment of prostate alterations were designed for the assessment of prostate pathology. Published by the ESUR in 2012, PI-RADS v1 was based on the total score of different MRI sequences with subsequent calculation. PI-RADS v2 was published by the American College of Radiology in 2015 and featured different assessment criteria for prostate peripheral and transitory zones.Aim. To assess the correlations of PI-RADS v1 and PI-RADS v2 with Gleason score values and to define their predictive values of the diagnosis of prostate cancer.Materials and methods. A retrospective analysis of 66 patients. Prostate specific antigen (PSA) value and the Gleason score (GS) were assessed. One the most malignant focal lesion was selected in the peripheral zone of each lobe of the prostate (91 in total). Statistical analysis was carried out applying SPSS software, v.23, p < 0.05.Results. Focal lesions assessed by PI-RADS v1 score: 10% – 1, 12% – 2, 41% – 3, 23% – 4, 14% – 5. Assessment applying PI-RADS v.2: 20% – 1, 7.5% – 2, 26%, 29.5%, and 17% were assessed by 3, 4, and 5 scores. Statistically relevant correlation was found only between GS and PI-RADS (p = 0.033).The positive predictive value of both versions of PI-RADS – 75%, negative predictive value of PI-RADS v1 – 46%, PI-RADS v2 – 43%.Conclusions. PI-RADS v1 was more statistically relevant in assessing the grade of tumour. Prediction values were similar in both versions

Highlights

Prostate cancer is the most common malignant tumour in males and, according to the 2012 dataThe role of different Prostate Imaging Reporting and Data System (PI-RADS) versions in prostate multiparametric magnetic resonance tomography assessment 45Modern randomized strategy for the biopsy provides insufficient prostate tumour detection
Focal lesions assessed by PI-RADS v1 score: 10% – 1, 12% – 2, 41% – 3, 23% – 4, 14% – 5
According to the guidelines of the European Association of Urology, transrectal ultrasound-guided (TRUS) 10–12-core needle biopsy is recommended in the case of elevated Prostate specific antigen (PSA) level and/or any abnormal findings during digital rectal examination [2]

Summary

Introduction

Prostate cancer is the most common malignant tumour in males and, according to the 2012 dataThe role of different PI-RADS versions in prostate multiparametric magnetic resonance tomography assessment 45Modern randomized strategy for the biopsy provides insufficient prostate tumour detection. More than 30% of clinically significant tumours are not detected during the initial biopsy while comparing with prostatectomy material, Gleason score is not sufficiently determined in 26–41% of cases [3, 4] This could lead to a false risk identification [3]. In 2012, the European Society of Urogenital Radiology (ESUR), released the standardized prostate MRI assessment called PI-RADS (Prostate Imagining Reporting and Data System) based on expert consensus guidelines [9]. These guidelines (PI-RADS v1) were based on the amount of points for the evaluation of each focal lesion with different sequences (T2, diffusion restriction (DWI, ADC), dynamic contrast, and selective spectroscopy) [9]. PI-RADS v2 was published by the American College of Radiology in 2015 and featured different assessment criteria for prostate peripheral and transitory zones

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