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Prostate Imaging-Reporting and Data System: Comparison of the Diagnostic Performance between Version 2.0 and 2.1 for
Hyun Soo Kim1, Ghee Young Kwon2, Min Je Kim1
1Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Korean Journal of Radiology
|May 3, 2021
Summary
The Prostate Imaging-Reporting and Data System version 2.1 (PI-RADSv2.1) shows improved diagnostic performance for clinically significant prostate cancer (csPCa) in the peripheral zone compared to PI-RADSv2.0. PI-RADSv2.1 offers higher accuracy and specificity, though with slightly reduced sensitivity.
Area of Science:
- Radiology
- Urologic Oncology
- Medical Imaging
Background:
- Prostate cancer diagnosis relies heavily on imaging and biopsy.
- The Prostate Imaging-Reporting and Data System (PI-RADS) provides standardized reporting for prostate MRI.
- Evaluating updates to diagnostic systems like PI-RADSv2.1 is crucial for improving cancer detection.
Purpose of the Study:
- To compare the diagnostic performance of PI-RADSv2.0 and PI-RADSv2.1 for detecting clinically significant prostate cancer (csPCa) in the peripheral zone (PZ).
- To assess differences in key performance metrics including AUC, sensitivity, specificity, PPV, NPV, and accuracy.
- To analyze cancer detection rates (CDR) across different PI-RADS categories between the two versions.
Main Methods:
- Retrospective analysis of 317 patients undergoing multiparametric MRI and targeted biopsy for PZ lesions.
- Definition of csPCa based on International Society of Urologic Pathology grade ≥ 2.
- Evaluation of diagnostic performance metrics by two independent readers using both PI-RADSv2.0 and PI-RADSv2.1.
Main Results:
- PI-RADSv2.1 demonstrated a higher Area Under the Curve (AUC) compared to PI-RADSv2.0 for both readers (0.856/0.858 vs. 0.795/0.747, p < 0.001).
- PI-RADSv2.1 showed improved specificity (76.6% vs. 52.8% for reader 1; 72.4% vs. 34.1% for reader 2) and accuracy (80.4% vs. 65.9% for reader 1; 78.9% vs. 54.3% for reader 2).
- Cancer detection rates for PI-RADS category 3 or 4 lesions were higher with PI-RADSv2.1, while sensitivity was slightly decreased.
Conclusions:
- PI-RADSv2.1 offers enhanced diagnostic performance, including improved AUC, specificity, PPV, and accuracy for csPCa in the PZ compared to PI-RADSv2.0.
- The updated version shows a higher cancer detection rate for intermediate PI-RADS categories (3 and 4).
- While sensitivity decreased slightly, the overall improvements suggest PI-RADSv2.1 is a more effective tool for diagnosing csPCa in the PZ.
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