Prostate Imaging Reporting and Data System and Likert Scoring System: Multiparametric MR Imaging Validation Study to...

Area of Science:

• Radiology
• Urology
• Oncology

Background:

• Prostate cancer diagnosis relies on prostate-specific antigen (PSA) levels and imaging.
• Multiparametric magnetic resonance imaging (mpMRI) is increasingly used for prostate cancer detection.
• Standardized reporting systems like PI-RADS aim to improve diagnostic accuracy.

Purpose of the Study:

• To compare the diagnostic performance of the Prostate Imaging Reporting and Data System (PI-RADS) and a Likert scale.
• To evaluate their effectiveness in detecting prostate cancer in patients undergoing initial prostate biopsy.

Main Methods:

• Prospective study of 118 patients with elevated PSA and normal DRE.
• Prebiopsy 1.5-T mpMRI including T2-weighted, diffusion-weighted (DW), and dynamic contrast-enhanced (DCE) sequences.
• Analysis of PI-RADS and Likert scale scores against biopsy results.
• Receiver operating characteristic (ROC) curves and interobserver variability analysis.

Main Results:

• Higher PI-RADS scores correlated with increased cancer-positive biopsy cores (P for trend <.0001).
• For detecting cancer in the peripheral zone, PI-RADS (score ≥9) showed 86.6% sensitivity and 82.4% specificity.
• Likert scale (score ≥3) showed 93.8% sensitivity and 73.6% specificity.
• Good interobserver agreement was observed for both PI-RADS (κ = 0.73) and Likert scale (κ = 0.80).

Conclusions:

• PI-RADS provides site-specific stratified risk of cancer-positive cores in biopsy-naive men.
• No significant difference was found between PI-RADS (score ≥9) and Likert scale (score ≥3) for cancer detection in the peripheral zone.