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Validation of Prostate Imaging-Reporting and Data System Version 2: A Retrospective Analysis.

Michael Nguyentat1, Alexander Ushinsky1, Alessandra Miranda-Aguirre1

  • 1Department of Radiological Sciences, University of California, Irvine Medical Center, Orange, CA.

Current Problems in Diagnostic Radiology
|November 12, 2017
PubMed
Summary
This summary is machine-generated.

Multiparametric MRI (mpMRI) with Prostate Imaging-Reporting and Data System version 2 (PI-RADSv2) accurately detects clinically significant prostate cancer. PI-RADSv2 shows excellent sensitivity and negative predictive value in both peripheral and transitional zones.

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Area of Science:

  • Radiology
  • Urology
  • Oncology

Background:

  • Prostate cancer diagnosis relies on accurate imaging and biopsy.
  • Multiparametric MRI (mpMRI) has improved prostate cancer detection.
  • Prostate Imaging-Reporting and Data System version 2 (PI-RADSv2) is a standardized scoring system for mpMRI.

Purpose of the Study:

  • To evaluate the accuracy of mpMRI using PI-RADSv2 for detecting clinically significant prostate cancer.
  • To assess accuracy in the overall prostate gland, peripheral zone (PZ), and transitional zone (TZ).
  • To compare PI-RADSv2 performance with previous criteria (PI-RADSv1).

Main Methods:

  • Retrospective analysis of 137 men with 231 prostate lesions undergoing MRI/ultrasound fusion biopsy.
  • Radiologist re-scored lesions using PI-RADSv2, blinded to PI-RADSv1 and biopsy results.
  • Statistical analyses included Spearman correlation, chi-squared, and logistic regression.

Main Results:

  • PI-RADSv2 correlated positively with Gleason scores (P < 0.001).
  • In the PZ, mpMRI showed 100% sensitivity and 100% negative predictive value.
  • PI-RADSv2 demonstrated high accuracy for clinically significant prostate cancer in both PZ and TZ, with improved AUC when combined with risk factors.

Conclusions:

  • PI-RADSv2 is highly effective for detecting clinically significant prostate cancer.
  • The system achieves excellent sensitivity and negative predictive value for both PZ and TZ lesions.
  • Combining PI-RADSv2 with other risk factors further enhances predictive accuracy.