You have accessJournal of UrologyCME1 Apr 2023PD39-09 IMPACT OF PROSTATE IMAGING QUALITY (PI-QUAL) SCORE ON THE DETECTION OF CLINICALLY SIGNIFICANT PROSTATE CANCER IN MEN UNDERGOING MRI-TARGETED BIOPSY Giorgio Brembilla, Salvatore Lavalle, Michele Cosenza, Tommaso Russo, Gabriele Sorce, Francesco Pellegrino, Daniele Robesti, Antony Pellegrino, Mattia Longoni, Pietro Scilipoti, Paolo Zaurito, Leonardo Quarta, Elio Mazzone, Armando Stabile, Bernhard Grubmuller, Shahrok Shariat, Antonio Esposito, Giorgio Gandaglia, De Cobelli Francesco, Francesco Montorsi, and Alberto Briganti Giorgio BrembillaGiorgio Brembilla More articles by this author , Salvatore LavalleSalvatore Lavalle More articles by this author , Michele CosenzaMichele Cosenza More articles by this author , Tommaso RussoTommaso Russo More articles by this author , Gabriele SorceGabriele Sorce More articles by this author , Francesco PellegrinoFrancesco Pellegrino More articles by this author , Daniele RobestiDaniele Robesti More articles by this author , Antony PellegrinoAntony Pellegrino More articles by this author , Mattia LongoniMattia Longoni More articles by this author , Pietro ScilipotiPietro Scilipoti More articles by this author , Paolo ZauritoPaolo Zaurito More articles by this author , Leonardo QuartaLeonardo Quarta More articles by this author , Elio MazzoneElio Mazzone More articles by this author , Armando StabileArmando Stabile More articles by this author , Bernhard GrubmullerBernhard Grubmuller More articles by this author , Shahrok ShariatShahrok Shariat More articles by this author , Antonio EspositoAntonio Esposito More articles by this author , Giorgio GandagliaGiorgio Gandaglia More articles by this author , De Cobelli FrancescoDe Cobelli Francesco More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Alberto BrigantiAlberto Briganti More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003342.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The Prostate Imaging Reporting and Data System (PI-RADS) guidelines represented the first step towards the definition of an optimal scan protocol, providing minimal technical requirements for mpMRI acquisition. However, PI-RADS does not provide measures to evaluate the quality of mpMRI. The Prostate Imaging Quality (PI-QUAL) score represents a tool that could provide clinicians with practical information on MRI quality that can influence patient care. However, evidence on its clinical impact is still limited. We aimed at investigating the impact of PI-QUAL scores on the diagnostic performance of mpMRI in a targeted biopsy cohort. METHODS: Overall, 200 consecutive patients who underwent both prostate mpMRI and subsequent biopsy at a single institution were included. All patients with at least one visible lesion at MRI (i.e. PI-RADS score≥3) underwent MRI-targeted biopsies with concomitant standard 12-core random systematic biopsy (TRUS-Bx). PI-QUAL scores were retrospectively assigned by two radiologists in consensus and were correlated to pre-biopsy PI-RADS scores and biopsy outcomes. Inter-reader agreement on PI-QUAL scores was determined on a subset of one-hundred men using percentage of agreement (PA), Agreement Coefficients (AC1 and AC2) and k coefficients. RESULTS: Median age was 67 years while the median PSA and PSA density was 6 ng/ml and 0.12 ng/ml2, respectively. The prevalence of any PCa at biopsy was 69% while the prevalence of csPCa was 46%. According to original MRI reports, 9% had a maximum score of PI-RADS 2, 31% had PI-RADS 3 and 60% had PI-RADS 4-5. Image quality was optimal (PI-QUAL ≥4) in 176/200 (88%) and suboptimal (PI-QUAL <4) in 24/200 (12%). The proportion of PI-RADS 3 scores referred for biopsy was higher in scans of suboptimal quality as compared to scans of optimal quality (42% vs 30%). In PI-QUAL <4 scans, the rate of false-positive findings of MRI was higher as compared to PI-QUAL ≥4 scans (58% vs 49%), as was the detection rate of targeted biopsies in PI-RADS ≥4 scans (50% vs 66%). Agreement on overall PI-QUAL scores was good (PA 83%; AC2 0.72; k=0.24). CONCLUSIONS: Scan quality may affect the diagnostic performance of prostate mpMRI in men undergoing MRI-targeted biopsy. Scans of suboptimal quality (PI-QUAL <4) were associated with a higher proportion of false positive biopsy referrals, especially for PI-RADS ≥4 scans. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1048 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Giorgio Brembilla More articles by this author Salvatore Lavalle More articles by this author Michele Cosenza More articles by this author Tommaso Russo More articles by this author Gabriele Sorce More articles by this author Francesco Pellegrino More articles by this author Daniele Robesti More articles by this author Antony Pellegrino More articles by this author Mattia Longoni More articles by this author Pietro Scilipoti More articles by this author Paolo Zaurito More articles by this author Leonardo Quarta More articles by this author Elio Mazzone More articles by this author Armando Stabile More articles by this author Bernhard Grubmuller More articles by this author Shahrok Shariat More articles by this author Antonio Esposito More articles by this author Giorgio Gandaglia More articles by this author De Cobelli Francesco More articles by this author Francesco Montorsi More articles by this author Alberto Briganti More articles by this author Expand All Advertisement PDF downloadLoading ...