Validation of PI-RADSv2: A Retrospective Analysis

Publication date: Available online 12 October 2017
Source:Current Problems in Diagnostic Radiology
Author(s): Michael Nguyentat, Alexander Ushinsky, Alessandra Miranda-Aguirre, Edward Uchio, Chandana Lall, Layla Shirkhoda, Thomas Lee, Christopher Green, Roozbeh Houshyar
PurposeUse MRI/TRUS fusion biopsies to determine the accuracy of multiparametric MRI (mpMRI), utilizing Prostate Imaging – Reporting and Data System version 2 (PI-RADSv2), for detecting clinically significant prostate cancer (csPCa) in the overall gland and specifically the peripheral zone (PZ) and transitional zone (TZ).MethodsA retrospective analysis of patients who underwent fusion biopsy identified 137 men with 231 prostate lesions was approved by the Institutional Review Board (IRB). Subjects initially classified under PI-RADSv1 criteria were re-graded utilizing PI-RADSv2 by a radiologist blinded to PI-RADSv1 score and biopsy results. Spearman′s correlation, chi-squared, and logistic regression analysis were performed.ResultsThere was positive correlation between PI-RADSv2 and Gleason scores (p < 0.001). In the PZ, mpMRI demonstrated 100% sensitivity, 100% NPV, and 35.9% PPV, compared to 100%, 100%, and 27.1%, respectively, for TZ lesions. When predicting csPCa, the PI-RADSv2 AUC for TZ lesions was 0.844 (95% CI 0.753–0.935, p < 0.001) and 0.769 (95% CI 0.684–0.854, p < 0.001) for PZ lesions. Combining PI-RADSv2 with additional risk factors (BMI, PSA density, DRE) improved the AUC.ConclusionsPI-RADSv2 achieves excellent sensitivity and NPV for both PZ and TZ lesions.



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