Related Experiment Video
Updated: Mar 1, 2026
A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
Published on: March 21, 2025
Gleason Score within Prostate Abnormal Areas Defined by Multiparametric Magnetic Resonance Imaging Did Not Vary
Hakim Slaoui1, Yann Neuzillet, Tarek Ghoneim
1Department of Urology, Hospital Foch, Suresnes, France.
Background:
We aim to correlate multiparametric magnetic resonance imaging (mpMRI) of the prostate reporting (Prostate Imaging Reporting and Data System [PI-RADS] version 2) with the Gleason score into both radical prostatectomy (RP) specimen and MRI fusion-targeted biopsies (FTB).
Methods:
mpMRI of 74 patients who underwent an RP after FTB were retrospectively reviewed. The Gleason score distribution was compared according to the PI-RADS score using the Kruskal-Wallis test. Results were compared to those of the mpMRI-guided biopsy of the same anatomical zone. For comparison, 903 RP specimen and their corresponding classical biopsies were also reviewed. Cohen's kappa concordance test was used to compare biopsies and prostatectomy specimen analyses.
Results:
An exact match between Gleason grade in RP specimen and FTB was found in 62% of the cases. There was no significant difference in Gleason score ≤7 (3 + 4) vs. ≥7 (4 + 3) distribution according to the PI-RADS scores (p = 0.096). Overall, Kappa coefficients were similar with MRI-targeted biopsies compared to classical biopsies (κ = 0.378, 95% CI [0.194-0.563], and κ = 0.316, 95% CI [0.259-0.374], respectively).
Conclusions:
PI-RADS score was not associated with significant differences regarding Gleason score distribution within target. Moreover, concordance of Gleason score in both MRI-targeted and classical biopsies with those within target in RP specimen was weak.
Insights
Prostate Imaging Reporting and Data System (PI-RADS) scores do not significantly correlate with Gleason scores from radical prostatectomy specimens or MRI-targeted biopsies. The concordance between biopsy methods and surgical specimens was found to be weak.
Area of Science:
- Urology
- Radiology
- Pathology
Background:
- Multiparametric magnetic resonance imaging (mpMRI) is increasingly used for prostate cancer detection.
- The Prostate Imaging Reporting and Data System (PI-RADS) version 2 provides a standardized method for reporting mpMRI findings.
- Accurate Gleason scoring is crucial for prostate cancer management and treatment decisions.
Purpose of the Study:
- To correlate PI-RADS version 2 scores with Gleason scores from both radical prostatectomy (RP) specimens and MRI fusion-targeted biopsies (FTB).
- To evaluate the concordance of Gleason scores between FTB and RP specimens.
- To compare the concordance of MRI-targeted biopsies with classical biopsies against RP specimens.
Main Methods:
- Retrospective review of mpMRI from 74 patients who underwent RP after FTB.
- Comparison of Gleason score distribution based on PI-RADS scores using the Kruskal-Wallis test.
- Assessment of concordance using Cohen's kappa test for both MRI-targeted and classical biopsies against RP specimens, with a comparison to 903 additional RP specimens and biopsies.
Main Results:
- An exact match in Gleason grade between RP specimens and FTB was observed in 62% of cases.
- No significant difference in Gleason score distribution (≤7 vs. ≥7) was found according to PI-RADS scores (p=0.096).
- Kappa coefficients indicated weak concordance for both MRI-targeted (κ=0.378) and classical biopsies (κ=0.316) compared to RP specimens.
Conclusions:
- PI-RADS scores did not demonstrate a significant association with Gleason score distribution within the targeted areas.
- The concordance of Gleason scores between both MRI-targeted biopsies and classical biopsies with radical prostatectomy specimens was weak.
- These findings suggest limitations in the current ability of PI-RADS to precisely predict Gleason scores and guide biopsy targeting accuracy.
