Characterization of high-grade prostate cancer at multiparametric MRI: assessment of PI-RADS version 2.1 and version 2 descriptors across 21 readers with varying experience (MULTI study) - Archive ouverte HAL Access content directly
Journal Articles Insights into Imaging Year : 2023

Characterization of high-grade prostate cancer at multiparametric MRI: assessment of PI-RADS version 2.1 and version 2 descriptors across 21 readers with varying experience (MULTI study)

Florian Di Franco
  • Function : Author
Sébastien Crouzet
Alain Ruffion
Mathilde Almeras
  • Function : Author
Bénédicte Cayot
  • Function : Author
Paul-Hugo Jouve de Guibert
  • Function : Author
Clément Pernet
  • Function : Author
Louis Perrier
  • Function : Author
Nicolas Stacoffe
  • Function : Author
Sarah Transin
  • Function : Author
Michel Abihanna
  • Function : Author
Sébastien Ronze
  • Function : Author
Alexandre Ben Cheikh
  • Function : Author
Flavie Bratan
  • Function : Author
Rémy Rosset
  • Function : Author
Domitille Cadiot
  • Function : Author
Leangsing Iv
  • Function : Author
Jean Champagnac
  • Function : Author
Nicolas Girouin
  • Function : Author
Olivier Lopez
  • Function : Author
Athivada Soto Thammavong
  • Function : Author

Abstract

Abstract Objective To assess PI-RADSv2.1 and PI-RADSv2 descriptors across readers with varying experience. Methods 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. Results 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. Conclusions 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.

Dates and versions

hal-04176536 , version 1 (03-08-2023)

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Cite

Florian Di Franco, Rémi Souchon, Sébastien Crouzet, Marc Colombel, Alain Ruffion, et al.. Characterization of high-grade prostate cancer at multiparametric MRI: assessment of PI-RADS version 2.1 and version 2 descriptors across 21 readers with varying experience (MULTI study). Insights into Imaging, 2023, 14 (1), pp.49. ⟨10.1186/s13244-023-01391-z⟩. ⟨hal-04176536⟩
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