Assessment of PI-RADS v2 categories ≥ 3 for diagnosis of clinically significant prostate cancer.

To assess the diagnostic accuracy of PI-RADS v2 categories ≥ 3 to detect clinically significant prostate cancer (csPCa) against histopathology of Transperineal Mapping Biopsy (TPMB).

IRB-approved retrospective cohort study included 47 men who had 3.0 T multi-parametric MRI (mpMRI) and TPMB of prostate. Two radiologists independently evaluated T2, DWI, ADC map, and DCE images using PI-RADS v2 categories. A third radiologist served as tie-breaker. PI-RADS v2 score (PS) ≥ 3 lesions were correlated with 3D model of TPMB (3DTPMB) results based on prostate sectors. Two groups of csPCa status were separately analyzed for accuracy measures at lesion and person levels: Group 1 with GS (Gleason Score) ≥ 7 and group 2 with tumor volume ≥ 0.5 cc. Inter-rater reliability for PS and MR lexicon was calculated.

Forty-seven patients with 3DTPMB had at least one lesion with PS ≥ 3 on mpMRI. PS of 5 had high PPV and high specificity of 100% at the lesion and person levels. Sensitivity of a PS ≥ 3 was 68.27% for group 1 and was 48.39% for group 2. Specificity was 93.56% for group 1 and was 95.53% for group 2. At the person level, sensitivity of PS ≥ 3 was 81.25% for group 1 and was 82.35% for group 2. Specificity was 32.26% for group 1 and was 53.85% for group 2.

PI-RADS v2 category of 5 had high PPV and specificity; however, combined PS ≥ 3 had mixed performance in detection of csPCa.

Abdominal radiology (New York). 2018 Aug 31 [Epub ahead of print]

Nayana U Patel, Kimberly E Lind, Kavita Garg, David Crawford, Priya N Werahera, Sajal S Pokharel

Department of Radiology, University of Colorado SOM, 12401 East 17th Avenue, Mail Stop L954, Aurora, CO, 80045, USA. ., Department of Health Systems, Management and Policy, Colorado School of Public Health, Aurora, CO, 80045, USA., Department of Radiology, University of Colorado SOM, 12401 East 17th Avenue, Mail Stop L954, Aurora, CO, 80045, USA., Department of Urologic Oncology, University of Colorado, Denver, Mail Stop # F 710, PO Box # 6510, Aurora, CO, 80045, USA., Department of Pathology and Department of Bioengineering, University of Colorado Anschutz Medical Campus, Mail Stop 8104, P. O. Box 6511, Aurora, CO, 80045, USA.

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