To assess PI-RADSv2.1 and PI-RADSv2 descriptors across readers with varying experience.
Twenty-one radiologists (7 experienced (≥ 5 years) seniors, 7 less experienced seniors and 7 juniors) assessed 240 'predefined' lesions from 159 pre-biopsy multiparametric prostate MRIs.
They specified their location (peripheral, transition or central zone) and size, and scored them using PI-RADSv2.1 and PI-RADSv2 descriptors. They also described and scored 'additional' lesions if needed. Per-lesion analysis assessed the 'predefined' lesions, using targeted biopsy as reference; per-lobe analysis included 'predefined' and 'additional' lesions, using combined systematic and targeted biopsy as reference. Areas under the curve (AUCs) quantified the performance in diagnosing clinically significant cancer (csPCa; ISUP ≥ 2 cancer). Kappa coefficients (κ) or concordance correlation coefficients (CCC) assessed inter-reader agreement.
At per-lesion analysis, inter-reader agreement on location and size was moderate-to-good (κ = 0.60-0.73) and excellent (CCC ≥ 0.80), respectively. Agreement on PI-RADSv2.1 scoring was moderate (κ = 0.43-0.47) for seniors and fair (κ = 0.39) for juniors. Using PI-RADSv2.1, juniors obtained a significantly lower AUC (0.74; 95% confidence interval [95%CI]: 0.70-0.79) than experienced seniors (0.80; 95%CI 0.76-0.84; p = 0.008) but not than less experienced seniors (0.74; 95%CI 0.70-0.78; p = 0.75). As compared to PI-RADSv2, PI-RADSv2.1 downgraded 17 lesions/reader (interquartile range [IQR]: 6-29), of which 2 (IQR: 1-3) were csPCa; it upgraded 4 lesions/reader (IQR: 2-7), of which 1 (IQR: 0-2) was csPCa. Per-lobe analysis, which included 60 (IQR: 25-73) 'additional' lesions/reader, yielded similar results.
Experience significantly impacted lesion characterization using PI-RADSv2.1 descriptors. As compared to PI-RADSv2, PI-RADSv2.1 tended to downgrade non-csPCa lesions, but this effect was small and variable across readers.
Insights into imaging. 2023 Mar 20*** epublish ***
Florian Di Franco, Rémi Souchon, Sébastien Crouzet, Marc Colombel, Alain Ruffion, Amna Klich, Mathilde Almeras, Laurent Milot, Muriel Rabilloud, Olivier Rouvière, MULTI Study Group
Hospices Civils de Lyon, Department of Imaging, Hôpital Edouard Herriot, 69437, Lyon, France., INSERM, LabTau, U1032, Lyon, France., Université de Lyon, Université Lyon 1, Lyon, France., Service de Biostatistique et Bioinformatique, Hospices Civils de Lyon, Pôle Santé Publique, 69003, Lyon, France., Hospices Civils de Lyon, Department of Imaging, Hôpital Edouard Herriot, 69437, Lyon, France. .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/36939970