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Analysis of interreader agreement in structured reports of pelvic multiparametric magnetic resonance imaging using
Xiang Liu1, Tingting Xie2, Zhaonan Sun1
1Department of Radiology, Peking University First Hospital, Beijing, China.
Purpose:
To evaluate interreader agreement on pelvic multiparametric magnetic resonance imaging (mpMRI) interpretation among radiologists using a structured reporting tool based on the METastasis Reporting and Data System for Prostate Cancer (MET-RADS-P) guidelines.
Methods:
A structured report for follow-up pelvic mpMRI for advanced prostate cancer (APC) patients was formulated based on MET-RADS-P guidelines. In total, 163 paired pelvic mpMRI examinations were performed from December 2017 to February 2021 on 105 patients with APC. These were retrospectively reviewed by two senior and two junior radiologists for metastatic lesion detection and were categorized by these readers using primary/secondary response assessment categories (RACs), with and without the structured report. Interreader agreement regarding metastasis detection and RAC scores was evaluated with Cohen's kappa and weighted Cohen's kappa statistics (K), respectively.
Results:
The two senior radiologists showed higher agreement with the reference standard for metastasis detection using the structured report (S1: K = 0.83; S2: K = 0.73) compared with the conventional report (S1: K = 0.72; S2: K = 0.61). Junior radiologists showed similar results (J1: 0.66 vs. 0.59; J2: 0.65 vs. 0.57). The overall agreement between the two senior radiologists was excellent for the primary RAC pattern using the structured reports (K = 0.81) and was substantial for secondary RAC categorization (K = 0.75). The interreader agreement of the two junior radiologists was substantial for both primary and secondary RAC values (K = 0.76, 0.68).
Conclusion:
Good interreader agreement was found for the follow-up assessment of APC patients between radiologists, where the pelvic mpMRI was reported using MET-RADS-P guidelines. This improvement applied to both metastatic lesion detection and qualitative RAC assessment.
Insights
A structured reporting tool based on MET-RADS-P guidelines improved radiologist agreement for detecting metastases in advanced prostate cancer patients. This enhances the reliability of pelvic multiparametric MRI assessments.
Area of Science:
- Radiology and Imaging
- Oncology
- Prostate Cancer Research
Background:
- Accurate assessment of metastatic disease is crucial for managing advanced prostate cancer (APC).
- Pelvic multiparametric MRI (mpMRI) is increasingly used for monitoring APC.
- Standardized reporting is needed to improve consistency in mpMRI interpretation.
Purpose of the Study:
- To evaluate interreader agreement among radiologists interpreting pelvic mpMRI.
- To assess the impact of a structured reporting tool based on MET-RADS-P guidelines.
- To determine agreement in metastatic lesion detection and response assessment categories.
Main Methods:
- A structured report based on MET-RADS-P guidelines was developed for follow-up pelvic mpMRI in APC patients.
- 163 paired mpMRI examinations from 105 APC patients were reviewed by four radiologists (two senior, two junior).
- Interreader agreement for metastasis detection and response assessment categories (RACs) was evaluated using Cohen's kappa statistics.
Main Results:
- The structured report improved agreement for metastasis detection by senior radiologists (K=0.83 vs. 0.72) and junior radiologists (K=0.66 vs. 0.59).
- Excellent agreement was observed between senior radiologists for primary RAC patterns (K=0.81) and substantial agreement for secondary RACs (K=0.75) using the structured report.
- Substantial agreement was also found between junior radiologists for both primary (K=0.76) and secondary RACs (K=0.68).
Conclusions:
- The MET-RADS-P-based structured reporting tool significantly improves interreader agreement in pelvic mpMRI interpretation for APC follow-up.
- This structured approach enhances consistency in both metastatic lesion detection and qualitative response assessment.
- The findings support the use of standardized reporting for more reliable mpMRI evaluations in advanced prostate cancer.
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