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Prostate MRI technical parameters standardization: A systematic review on adherence to PI-RADSv2 acquisition protocol
Renato Cuocolo1, Arnaldo Stanzione1, Andrea Ponsiglione1
1Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via Pansini 5, Naples, Italy.
Purpose:
The Prostate Imaging-Reporting and Data System has been developed to standardize prostate MRI in terms of acquisition, interpretation and reporting. It received a major revision in late 2014 (PI-RADSv2). Recently, doubts have been raised on imaging facilities adherence to its acquisition protocol. With this systematic review, we assessed adherence to PI-RADSv2 minimum technical specifications in literature, to achieve a better understanding of issues limiting their diffusion.
Method:
Multiple medical literature databases were extensively searched to retrieve original studies published after January 2016 performing prostate MRI. Information pertaining acquisition protocols and patient enrolment were recorded for analysis. Technical parameters were dichotomized in relation to adherence to the corresponding minimal technical requirements.
Results:
A total of 150 studies were included for analysis. Only 5% reported every technical parameter specified in the PI-RADSv2 document requirements, none of which completely met guideline specifications. Overall, 19% were in line with PI-RADSv2 for all reported MRI acquisition parameters. The adherence was lowest for T2-weighted frequency in-plane resolution (12%), diffusion-weighted imaging field of view (40%), apparent diffusion coefficient map low b-value (27%) and dynamic contrast-enhanced imaging temporal resolution (43%). Considering its role in image interpretation, it must be highlighted that only 59% of studies reporting diffusion-weighted imaging high b-value follow recommendations.
Conclusions:
Adherence to PI-RADSv2 minimum technical standards is heterogeneous in the scientific community. Our findings endorse the need for greater diffusion of PI-RADSv2 guidelines to achieve protocol standardization and support the notion that some requirements might benefit from streamlining to improve clinical applicability.
Insights
Adherence to Prostate Imaging-Reporting and Data System (PI-RADSv2) technical standards for prostate MRI is inconsistent among studies. Greater guideline dissemination and potential streamlining are needed for better standardization and clinical applicability.
Area of Science:
- Radiology
- Medical Imaging
Background:
- The Prostate Imaging-Reporting and Data System (PI-RADSv2) aims to standardize prostate MRI acquisition, interpretation, and reporting.
- Recent concerns question adherence to PI-RADSv2 acquisition protocols in clinical practice.
Purpose of the Study:
- To systematically review and assess adherence to PI-RADSv2 minimum technical specifications in published prostate MRI studies.
- To identify factors limiting the widespread adoption of PI-RADSv2 acquisition protocols.
Main Methods:
- A systematic search of medical literature databases was conducted for original studies published after January 2016 on prostate MRI.
- Acquisition protocols and patient enrollment data were extracted and analyzed.
- Technical parameters were evaluated against PI-RADSv2 minimal technical requirements.
Main Results:
- Out of 150 included studies, only 5% reported all PI-RADSv2 technical parameters, and none fully met all specifications.
- Overall adherence to PI-RADSv2 acquisition parameters was observed in 19% of studies.
- Lowest adherence rates were found for T2-weighted in-plane resolution (12%), DWI field of view (40%), ADC map low b-value (27%), and DCE-MRI temporal resolution (43%).
- Only 59% of studies followed recommendations for diffusion-weighted imaging high b-value.
Conclusions:
- Adherence to PI-RADSv2 minimum technical standards is highly variable within the scientific literature.
- Enhanced dissemination of PI-RADSv2 guidelines is crucial for achieving protocol standardization.
- Some PI-RADSv2 requirements may need revision to improve clinical applicability and facilitate wider adoption.
