You have accessJournal of UrologyImaging/Radiology: Uroradiology II1 Apr 2018MP20-19 A PROSPECTIVE DIAGNOSTIC ACCURACY STUDY OF PROSTATE IMAGING REPORTING AND DATA SYSTEM VERSION 2 ON 3 TESLA MULTIPARAMETRIC MULTIPARAMETRIC MAGNETIC RESONANCE IMAGING IN DETECTING PROSTATE CANCER WITH WHOLE-MOUNT PATHOLOGY Gianluca Giannarini, Rossano Girometti, Stefano Sioletic, Marta Rossanese, Vito Palumbo, Mattia Calandriello, Alessandro Crestani, Chiara Zuiani, and Vincenzo Ficarra Gianluca GiannariniGianluca Giannarini More articles by this author , Rossano GiromettiRossano Girometti More articles by this author , Stefano SioleticStefano Sioletic More articles by this author , Marta RossaneseMarta Rossanese More articles by this author , Vito PalumboVito Palumbo More articles by this author , Mattia CalandrielloMattia Calandriello More articles by this author , Alessandro CrestaniAlessandro Crestani More articles by this author , Chiara ZuianiChiara Zuiani More articles by this author , and Vincenzo FicarraVincenzo Ficarra More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.689AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Little data is available on the performance of the Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) on 3 Tesla multiparametric magnetic resonance imaging (mpMRI) in detecting prostate cancer (PCa) on definitive pathology after radical prostatectomy. In this study, we assessed the accuracy of PI-RADS v2 in detecting any PCa and clinically significant PCa (csPCa) on 3 Tesla mpMRI using whole-mount histology as the standard of reference. METHODS Between May 2016 and February 2017 we prospectively enrolled patients with biopsy-proven PCa who underwent 3 Tesla mpMRI before radical prostatectomy. Three radiologists with 8, 7 and 2 years of mpMRI experience, who were blinded to final pathology, independently mapped and scored imaging findings according to PI-RADS v2 criteria. One experienced uropathologist processed prostate specimens using whole-mount protocol, and mapped all cancers according to the PI-RADS v2 39-sector scheme. Based on a lesion-by-lesion mpMRI-to-whole-mount-pathology matching, we calculated sensitivity and specificity in detecting PCa and csPCa defined according to Epstein criteria, using PI-RADS ≥3 and ≥4 score as thresholds. We also assessed inter-reader agreement using Cohen′s weighted-kappa statistic. RESULTS Included were 48 patients (median age 68 years, median PSA 7.2 ng/ml) with 71 cancers on final histology (median size 16 mm, Gleason score ≥7 in 46 cases, stage ≥pT3 in 22 cases). Lesions were in the peripheral zone, transition zone or both in 58, 9 and 4 cases, respectively. On a per-lesion basis, sensitivity was slightly higher with PI-RADS ≥3 vs. ≥4 threshold (range 0.55-0.62 vs. 0.48-0.60 for any PCa, and 0.67-0.74 vs. 0.61-0.72 for csPCa, respectively) at the expense of lower specificity (range 0.11-0.30 vs. 0.56-0.71 for any PCa, and 0.28-0.30 vs. 0.55-0.71 for csPCa, respectively). Accuracy improved on a per-patient basis, with 0.64-0.77 sensitivity and 0.73-0.83 specificity for csPCa with a PI-RADS ≥4 threshold. Inter-reader agreement was moderate to substantial (k=0.47-0.72 vs. 0.51-0.71 for PI-RADS thresholds ≥3 and ≥4, respectively). CONCLUSIONS PI-RADS v2 showed good diagnostic performance in detecting csPCa, with acceptable inter-reader agreement. PI-RADS ≥4 threshold offered a better trade-off between sensitivity and specificity. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e261 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Gianluca Giannarini More articles by this author Rossano Girometti More articles by this author Stefano Sioletic More articles by this author Marta Rossanese More articles by this author Vito Palumbo More articles by this author Mattia Calandriello More articles by this author Alessandro Crestani More articles by this author Chiara Zuiani More articles by this author Vincenzo Ficarra More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...