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dc.contributor.authorGreer, Matthew D
dc.contributor.authorShih, Joanna H
dc.contributor.authorLay, Nathan
dc.contributor.authorBarrett, Tristan
dc.contributor.authorBittencourt, Leonardo
dc.contributor.authorBorofsky, Samuel
dc.contributor.authorKabakus, Ismail
dc.contributor.authorLaw, Yan Mee
dc.contributor.authorMarko, Jamie
dc.contributor.authorShebel, Haytham
dc.contributor.authorMerino, Maria J
dc.contributor.authorWood, Bradford J
dc.contributor.authorPinto, Peter A
dc.contributor.authorSummers, Ronald M
dc.contributor.authorChoyke, Peter L
dc.contributor.authorTurkbey, Baris
dc.date.accessioned2019-09-13T11:59:14Z
dc.date.available2019-09-13T11:59:14Z
dc.date.issued2019-03-27
dc.identifier.issn0361-803X
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/296818
dc.description.abstractOBJECTIVE: The purpose of this study was to evaluate agreement among radiologists in detecting and assessing prostate cancer at multiparametric MRI using Prostate Imaging Reporting and Data System version 2 (PI-RADSv2). MATERIALS AND METHODS: Treatment-naïve patients underwent 3-T multipara-metric MRI between April 2012 and June 2015. Among the 163 patients evaluated, 110 underwent prostatectomy after MRI and 53 had normal MRI findings and transrectal ultrasound-guided biopsy results. Nine radiologists participated (three each with high, intermediate, and low levels of experience). Readers interpreted images of 58 patients on average (range, 56-60) using PI-RADSv2. Prostatectomy specimens registered to MRI were ground truth. Interob-server agreement was evaluated with the index of specific agreement for lesion detection and kappa and proportion of agreement for PI-RADS category assignment. RESULTS: The radiologists detected 336 lesions. Sensitivity for index lesions was 80.9% (95% CI, 75.1-85.9%), comparable across reader experience (p = 0.392). Patient-level specificity was experience dependent; highly experienced readers had 84.0% specificity versus 55.2% for all others (p < 0.001). Interobserver agreement was excellent for detecting index lesions (index of specific agreement, 0.871; 95% CI, 0.798-0.923). Agreement on PI-RADSv2 category assignment of index lesions was moderate (κ = 0.419; 95% CI, 0.238-0.595). For individual category assignments, proportion of agreement was slight for PI-RADS category 3 (0.208; 95% CI, 0.086-0.284) but substantial for PI-RADS category 4 (0.674; 95% CI, 0.540-0.776). However, proportion of agreement for T2-weighted PI-RADS 4 in the transition zone was 0.250 (95% CI, 0.108-0.372). Proportion of agreement for category assignment of index lesions on dynamic contrast-enhanced MR images was 0.822 (95% CI, 0.728-0.903), on T2-weighted MR images was 0.515 (95% CI, 0.430-0623), and on DW images was 0.586 (95% CI, 0.495-0.682). Proportion of agreement for dominant lesion was excellent (0.828; 95% CI, 0.742-0.913). CONCLUSION: Radiologists across experience levels had excellent agreement for detecting index lesions and moderate agreement for category assignment of lesions using PI-RADS. Future iterations of PI-RADS should clarify PI-RADS 3 and PI-RADS 4 in the transition zone.
dc.format.mediumPrint-Electronic
dc.languageeng
dc.publisherAmerican Roentgen Ray Society
dc.rightsAll rights reserved
dc.titleInterreader Variability of Prostate Imaging Reporting and Data System Version 2 in Detecting and Assessing Prostate Cancer Lesions at Prostate MRI.
dc.typeArticle
prism.endingPage8
prism.publicationDate2019
prism.publicationNameAJR Am J Roentgenol
prism.startingPage1
dc.identifier.doi10.17863/CAM.43862
dcterms.dateAccepted2018-11-28
rioxxterms.versionofrecord10.2214/AJR.18.20536
rioxxterms.versionAM
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2019-03-27
dc.contributor.orcidBarrett, Tristan [0000-0002-1180-1474]
dc.identifier.eissn1546-3141
rioxxterms.typeJournal Article/Review
cam.issuedOnline2019-03-27
cam.orpheus.counter15*
rioxxterms.freetoread.startdate2100-01-01


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