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Interreader Agreement with Prostate Imaging Reporting and Data System Version 2 for Prostate Cancer Detection: A
Kye Jin Park1, Sang Hyun Choi1, Ji Sung Lee2,3
1Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
The Journal of Urology
|June 20, 2020
Summary
Prostate Imaging Reporting and Data System (PI-RADS) version 2 shows substantial interreader agreement for prostate cancer detection. Agreement levels are comparable to PI-RADS version 1, with reader experience influencing results.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Prostate cancer diagnosis relies heavily on Magnetic Resonance Imaging (MRI) interpretation.
- The Prostate Imaging Reporting and Data System (PI-RADS) standardizes reporting for MRI of the prostate.
- Evaluating interreader agreement is crucial for assessing the reliability of diagnostic systems like PI-RADS.
Purpose of the Study:
- To evaluate the interreader agreement of PI-RADS version 2 for prostate cancer detection.
- To compare the agreement of PI-RADS version 2 with PI-RADS version 1.
- To identify factors influencing agreement within PI-RADS version 2 assessments.
Main Methods:
- A systematic literature search was conducted in MEDLINE, Embase, and Cochrane Library (2015-2019).
- Original research on PI-RADS version 2 interreader agreement was included and quality assessed.
- Pooled kappa (κ) values were calculated, and head-to-head comparisons with version 1 were performed. Subgroup analyses and meta-regression were utilized.
Main Results:
- Thirty studies with 4,095 patients were analyzed, yielding a pooled κ of 0.61 for PI-RADS version 2.
- PI-RADS version 2 demonstrated substantial agreement (κ=0.61) with a cutoff of 4 or higher, and moderate agreement (κ=0.57) with a cutoff of 3 or higher.
- Reader experience was identified as a significant factor affecting study heterogeneity (p=0.01).
Conclusions:
- PI-RADS version 2 offers substantial interreader agreement for overall scoring in suspected prostate cancer.
- The level of agreement for PI-RADS version 2 is comparable to that of PI-RADS version 1.
- Standardized interpretation and reader experience are key to reliable PI-RADS assessments.
