Comparison of diagnostic performance between two prostate imaging reporting and data system versions: A systematic...

Area of Science:

• Radiology
• Oncology
• Diagnostic Accuracy

Background:

• Prostate cancer (PCa) detection relies on accurate imaging interpretation.
• The Prostate Imaging Reporting and Data System (PI-RADS) provides standardized reporting for prostate MRI.
• Evolving versions of PI-RADS aim to enhance diagnostic performance.

Purpose of the Study:

• To compare the diagnostic performance of PI-RADS version 1 (PI-RADS v1) and PI-RADS version 2 (PI-RADS v2).
• To evaluate the effectiveness of PI-RADS v2 in detecting prostate cancer (PCa).

Main Methods:

• Systematic literature search conducted across multiple databases (MEDLINE, EMBASE, Cochrane Library, Google Scholar, CNKI, Wanfang Data) up to September 31, 2018.
• Meta-analysis of 14 studies with head-to-head comparisons of PI-RADS v1 and v2, involving 1682 patients.
• Calculation of pooled sensitivity and specificity, with subgroup analyses and meta-regression to assess heterogeneity and quality using the QUADAS-2 tool.

Main Results:

• Pooled sensitivity: PI-RADS v1 (85.37%) vs. PI-RADS v2 (87.79%).
• Pooled specificity: PI-RADS v1 (77.26%) vs. PI-RADS v2 (76.73%).
• No substantial difference in overall diagnostic accuracy between PI-RADS v1 and v2 (P > 0.05 for both sensitivity and specificity). PI-RADS v2 showed a trend towards higher sensitivity in the transitional zone.

Conclusions:

• PI-RADS v2 offers a slight increase in sensitivity for PCa detection but with a minor decrease in specificity compared to PI-RADS v1.
• Both PI-RADS v1 and PI-RADS v2 exhibit comparable overall diagnostic accuracy for prostate cancer.
• The findings suggest that PI-RADS v2 maintains a similar level of diagnostic performance to its predecessor.