Related Experiment Video
Updated: Jan 4, 2026
06:08
A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
Published on: March 21, 2025
1.0K
Performance and inter-observer variability of prostate MRI (PI-RADS version 2) outside high-volume centres
Kimia Kohestani1,2, Jonas Wallström3,4, Niclas Dehlfors4
1Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Scandinavian Journal of Urology
|October 30, 2019
Summary
Prostate MRI shows moderate detection rates for prostate cancer (PC) but has significant inter-reader variability. This highlights the need for non-specialized centers to assess their MRI performance before potentially omitting biopsies.
Area of Science:
- Radiology
- Urology
- Oncology
Background:
- Pre-biopsy MRI is increasingly used for prostate cancer (PC) diagnosis.
- Its effectiveness and consistency outside specialized centers are not well-established.
Purpose of the Study:
- To evaluate the sensitivity and inter-observer variability of prostate MRI.
- To assess performance using radical prostatectomy (RP) specimens as the reference standard.
Main Methods:
- Retrospective analysis of 97 men undergoing MRI and RP.
- Three blinded readers assessed prostate MRIs using PI-RADS v2 scoring.
- Tumor detection was based on PI-RADS scores (3-5) and a 24-sector system matching MRI to whole mount sections.
Main Results:
- Index tumor detection rates ranged from 54-76% depending on PI-RADS score inclusion (3-5 or 4-5).
- Detection rates for aggressive tumors (GS ≥ 4+3) were higher (79.2-83.1%).
- Inter-reader agreement (κ values) was moderate (0.41-0.51).
Conclusions:
- Prostate MRI demonstrates moderate detection rates for clinically significant PC.
- Significant variability exists between readers in non-specialized settings.
- Clinics must evaluate their prostate MRI performance before considering biopsy omission in men with negative scans.
