Prostate Imaging and Data Reporting System Version 2 as a Radiology Performance Metric: An Analysis of 18 Abdominal Radiologists.

To determine expected trained provider performance dispersion in Prostate Imaging and Data Reporting System version 2 (PI-RADS v2) positive predictive values (PPVs).

This single-center quality assurance retrospective cohort study evaluated 5,556 consecutive prostate MRIs performed on 4,593 patients. Studies were prospectively interpreted from October 8, 2016, to July 31, 2020, by 18 subspecialty-trained abdominal radiologists (1-22 years' experience; median MRIs per radiologist: 232, first-to-third quartile range [Q1-Q3]: 128-440; 13 interpreted at least 30 MRIs with a reference standard). Maximum prospectively reported whole-gland PI-RADS v2 score was compared to post-MRI biopsy histopathology obtained within 2 years. The primary outcome was PPV of MRI by provider stratified by maximum whole-gland PI-RADS v2 score.

Median provider-level PPVs for the radiologists who interpreted ≥30 MRIs with a reference standard were PI-RADS 3 (22.1%; Q1-Q3: 10.0%-28.6%), PI-RADS 4 (49.2%; Q1-Q3: 41.4%-50.0%), PI-RADS 5 (81.8%; Q1-Q3: 77.1%-84.4%). Overall, the maximum whole-gland PI-RADS v2 score was PI-RADS 1 to 2 (34.6% [1,925]), PI-RADS 3 (8.5% [474]), PI-RADS 4 (21.0% [1,166]), PI-RADS 5 (18.3% [1,018]), no PI-RADS score (17.5% [973]). System-level (all providers) PPVs for maximum PI-RADS v2 scores were 20.0% (95% confidence interval [CI]: 15.7%-24.9%) for PI-RADS 3, 48.5% (95% CI: 44.8%-52.2%) for PI-RADS 4, and 80.1% for PI-RADS 5 (95% CI: 75.7%-83.9%).

Subspecialty-trained abdominal radiologists with a wide range of experience can obtain consistent positive predictive values for PI-RADS v2 scores of 3 to 5. These data can be used for quality assurance benchmarking.

Journal of the American College of Radiology : JACR. 2021 Apr 10 [Epub ahead of print]

Matthew S Davenport, Elizabeth Downs, Arvin K George, Nicole E Curci, Bassel R Salka, Theodore Q Sullivan, Prasad R Shankar

Department of Radiology, Michigan Medicine, Ann Arbor, Michigan; Michigan Radiology Quality Collaborative, Michigan Medicine, Ann Arbor, Michigan; Department of Urology, Michigan Medicine, Ann Arbor, Michigan., Health Information Technology & Services, Michigan Medicine, Ann Arbor, Michigan., Department of Urology, Michigan Medicine, Ann Arbor, Michigan., Department of Radiology, Michigan Medicine, Ann Arbor, Michigan; Michigan Radiology Quality Collaborative, Michigan Medicine, Ann Arbor, Michigan., Michigan Medicine, Department of Radiology Associate Chair for Quality and Safety and Chair of the Departmental Peer Review Committee, School of Medicine, University of Michigan, Ann Arbor, Michigan., Department of Radiology, Michigan Medicine, Ann Arbor, Michigan., Department of Radiology, Michigan Medicine, Ann Arbor, Michigan; Michigan Radiology Quality Collaborative, Michigan Medicine, Ann Arbor, Michigan. Electronic address: .