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Intra- and interreader reproducibility of PI-RADSv2: A multireader study

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Peer-reviewed

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Article

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Authors

Smith, CP 
Harmon, SA 
Bittencourt, LK 
Law, YM 

Abstract

Background: The Prostate Imaging Reporting and Data System version 2 (PI-RADSv2) has been in use since 2015; while interreader reproducibility has been studied, there has been a paucity of studies investigating the intrareader reproducibility of PI-RADSv2. Purpose: To evaluate both intra- and interreader reproducibility of PI-RADSv2 in the assessment of intraprostatic lesions using multiparametric magnetic resonance imaging (mpMRI). Study Type: Retrospective. Population/Subjects: In all, 102 consecutive biopsy-naïve patients who underwent prostate MRI and subsequent MR/transrectal ultrasonography (MR/TRUS)-guided biopsy. Field Strength/Sequences: Prostate mpMRI at 3T using endorectal with phased array surface coils (TW MRI, DW MRI with ADC maps and b2000 DW MRI, DCE MRI). Assessment: Previously detected and biopsied lesions were scored by four readers from four different institutions using PI-RADSv2. Readers scored lesions during two readout rounds with a 4-week washout period. Statistical Tests: Kappa (κ) statistics and specific agreement (Po) were calculated to quantify intra- and interreader reproducibility of PI-RADSv2 scoring. Lesion measurement agreement was calculated using the intraclass correlation coefficient (ICC). Results: Overall intrareader reproducibility was moderate to substantial (κ = 0.43–0.67, Po = 0.60–0.77), while overall interreader reproducibility was poor to moderate (κ = 0.24, Po = 46). Readers with more experience showed greater interreader reproducibility than readers with intermediate experience in the whole prostate (P = 0.026) and peripheral zone (P = 0.002). Sequence-specific interreader agreement for all readers was similar to the overall PI-RADSv2 score, with κ = 0.24, 0.24, and 0.23 and Po = 0.47, 0.44, and 0.54 in T2-weighted, diffusion-weighted imaging (DWI), and dynamic contrast-enhanced (DCE), respectively. Overall intrareader and interreader ICC for lesion measurement was 0.82 and 0.71, respectively. Data Conclusion: PI-RADSv2 provides moderate intrareader reproducibility, poor interreader reproducibility, and moderate interreader lesion measurement reproducibility. These findings suggest a need for more standardized reader training in prostate MRI. Level of Evidence: 2. Technical Efficacy: Stage 2.

Description

Keywords

MRI, PI-RADS, prostate cancer, reader reproducibility, Adult, Aged, Aged, 80 and over, Algorithms, Biopsy, Contrast Media, Diffusion Magnetic Resonance Imaging, Humans, Image-Guided Biopsy, Magnetic Resonance Imaging, Male, Middle Aged, Multiparametric Magnetic Resonance Imaging, Observer Variation, Prostate, Prostate-Specific Antigen, Prostatic Neoplasms, Reference Standards, Reproducibility of Results, Retrospective Studies, Ultrasonography

Journal Title

JMRI: Journal of Magnetic Resonance Imaging

Conference Name

Journal ISSN

1053-1807
1522-2586

Volume Title

46

Publisher

Wiley-Blackwell

Rights

All rights reserved
Sponsorship
Cancer Research Uk (None)