TY - JOUR
T1 - Variability of the positive predictive value of PI-RADS for prostate MRI across 26 centers
T2 - Experience of the society of abdominal radiology prostate cancer disease-focused panel
AU - Westphalen, Antonio C.
AU - McCulloch, Charles E.
AU - Anaokar, Jordan M.
AU - Arora, Sandeep
AU - Barashi, Nimrod S.
AU - Barentsz, Jelle O.
AU - Bathala, Tharakeswara K.
AU - Bittencourt, Leonardo K.
AU - Booker, Michael T.
AU - Braxton, Vaughn G.
AU - Carroll, Peter R.
AU - Casalino, David D.
AU - Chang, Silvia D.
AU - Coakley, Fergus V.
AU - Dhatt, Ravjot
AU - Eberhardt, Steven C.
AU - Foster, Bryan R.
AU - Froemming, Adam T.
AU - Fütterer, Jurgen J.
AU - Ganeshan, Dhakshina M.
AU - Gertner, Mark R.
AU - Gettle, Lori Mankowski
AU - Ghai, Sangeet
AU - Gupta, Rajan T.
AU - Hahn, Michael E.
AU - Houshyar, Roozbeh
AU - Kim, Candice
AU - Kim, Chan Kyo
AU - Lall, Chandana
AU - Margolis, Daniel J.A.
AU - McRae, Stephen E.
AU - Oto, Aytekin
AU - Parsons, Rosaleen B.
AU - Patel, Nayana U.
AU - Pinto, Peter A.
AU - Polascik, Thomas J.
AU - Spilseth, Benjamin
AU - Starcevich, Juliana B.
AU - Tammisetti, Varaha S.
AU - Taneja, Samir S.
AU - Turkbey, Baris
AU - Verma, Sadhna
AU - Ward, John F.
AU - Warlick, Christopher A.
AU - Weinberger, Andrew R.
AU - Yu, Jinxing
AU - Zagoria, Ronald J.
AU - Rosenkrantz, Andrew B.
N1 - Publisher Copyright:
© RSNA, 2020.
PY - 2020/7
Y1 - 2020/7
N2 - Background: Prostate MRI is used widely in clinical care for guiding tissue sampling, active surveillance, and staging. The Prostate Imaging Reporting and Data System (PI-RADS) helps provide a standardized probabilistic approach for identifying clinically significant prostate cancer. Despite widespread use, the variability in performance of prostate MRI across practices remains unknown. Purpose: To estimate the positive predictive value (PPV) of PI-RADS for the detection of high-grade prostate cancer across imaging centers. Materials and Methods: This retrospective cross-sectional study was compliant with the HIPAA. Twenty-six centers with members in the Society of Abdominal Radiology Prostate Cancer Disease-focused Panel submitted data from men with suspected or biopsy-proven untreated prostate cancer. MRI scans were obtained between January 2015 and April 2018. This was followed with targeted biopsy. Only men with at least one MRI lesion assigned a PI-RADS score of 2–5 were included. Outcome was prostate cancer with Gleason score (GS) greater than or equal to 3+4 (International Society of Urological Pathology grade group ≥2). A mixed-model logistic regression with institution and individuals as random effects was used to estimate overall PPVs. The variability of observed PPV of PI-RADS across imaging centers was described by using the median and interquartile range. Results: The authors evaluated 3449 men (mean age, 65 years 6 8 [standard deviation]) with 5082 lesions. Biopsy results showed 1698 cancers with GS greater than or equal to 3+4 (International Society of Urological Pathology grade group ≥2) in 2082 men. Across all centers, the estimated PPV was 35% (95% confidence interval [CI]: 27%, 43%) for a PI-RADS score greater than or equal to 3 and 49% (95% CI: 40%, 58%) for a PI-RADS score greater than or equal to 4. The interquartile ranges of PPV at these same PI-RADS score thresholds were 27%–44% and 27%–48%, respectively. Conclusion: The positive predictive value of the Prostate Imaging and Reporting Data System was low and varied widely across centers.
AB - Background: Prostate MRI is used widely in clinical care for guiding tissue sampling, active surveillance, and staging. The Prostate Imaging Reporting and Data System (PI-RADS) helps provide a standardized probabilistic approach for identifying clinically significant prostate cancer. Despite widespread use, the variability in performance of prostate MRI across practices remains unknown. Purpose: To estimate the positive predictive value (PPV) of PI-RADS for the detection of high-grade prostate cancer across imaging centers. Materials and Methods: This retrospective cross-sectional study was compliant with the HIPAA. Twenty-six centers with members in the Society of Abdominal Radiology Prostate Cancer Disease-focused Panel submitted data from men with suspected or biopsy-proven untreated prostate cancer. MRI scans were obtained between January 2015 and April 2018. This was followed with targeted biopsy. Only men with at least one MRI lesion assigned a PI-RADS score of 2–5 were included. Outcome was prostate cancer with Gleason score (GS) greater than or equal to 3+4 (International Society of Urological Pathology grade group ≥2). A mixed-model logistic regression with institution and individuals as random effects was used to estimate overall PPVs. The variability of observed PPV of PI-RADS across imaging centers was described by using the median and interquartile range. Results: The authors evaluated 3449 men (mean age, 65 years 6 8 [standard deviation]) with 5082 lesions. Biopsy results showed 1698 cancers with GS greater than or equal to 3+4 (International Society of Urological Pathology grade group ≥2) in 2082 men. Across all centers, the estimated PPV was 35% (95% confidence interval [CI]: 27%, 43%) for a PI-RADS score greater than or equal to 3 and 49% (95% CI: 40%, 58%) for a PI-RADS score greater than or equal to 4. The interquartile ranges of PPV at these same PI-RADS score thresholds were 27%–44% and 27%–48%, respectively. Conclusion: The positive predictive value of the Prostate Imaging and Reporting Data System was low and varied widely across centers.
UR - https://www.scopus.com/pages/publications/85086495613
U2 - 10.1148/radiol.2020190646
DO - 10.1148/radiol.2020190646
M3 - Article
C2 - 32315265
AN - SCOPUS:85086495613
SN - 0033-8419
VL - 296
SP - 76
EP - 84
JO - Radiology
JF - Radiology
IS - 1
ER -
SDG 3 Good Health and Well-being