PI-QUAL version 2: A Multi-Reader reproducibility study on multiparametric MRI from a tertiary referral center

Area of Science:

• Radiology
• Medical Imaging
• Quality Assessment

Background:

• Multiparametric MRI (mpMRI) is crucial for prostate cancer assessment.
• Standardized quality assessment tools are needed to ensure reliable mpMRI interpretation.
• The Prostate Imaging Quality (PI-QUAL) v.2 is a newer version designed to improve upon previous quality metrics.

Purpose of the Study:

• To evaluate the inter-reader and intra-reader agreement of the PI-QUAL v.2 for prostate mpMRI.
• To assess how radiologist expertise influences the reliability of PI-QUAL v.2 scores.
• To compare PI-QUAL v.2 with its predecessor, PI-QUAL v.1.

Main Methods:

• Six radiologists with varying expertise assessed 50 prostate mpMRI scans using PI-QUAL v.2.
• Assessments were repeated after a 2-week interval, with PI-QUAL v.1 also used for comparison.
• Gwet's AC1 index was employed to quantify inter-reader and intra-reader agreement.

Main Results:

• Overall moderate inter-reader agreement for PI-QUAL v.2 (Gwet's AC1 = 0.55), with higher agreement among expert readers.
• Intra-reader agreement ranged from moderate to perfect (Gwet's AC1 = 0.43-1.00) and improved with expertise.
• Higher reproducibility was observed for DWI and DCE sequences compared to T2w sequences.

Conclusions:

• PI-QUAL v.2 demonstrates moderate reliability for standardizing prostate mpMRI quality evaluations.
• The tool's effectiveness is influenced by radiologist expertise.
• PI-QUAL v.2 offers a reliable method for quality control in prostate mpMRI within a tertiary referral setting.