The diagnostic performance in clinically significant prostate cancer with PI-RADS version 2.1: simplified bpMRI versus standard mpMRI

Jihui Song; Chenglin Zhao; Fei Zhang; Yingdi Yuan; Lee M Wang; Vivek Sah; Jun Zhang; Wencai Weng; Zhenghan Yang; Zhenchang Wang; Liang Wang

doi:10.1007/s00261-022-03750-8

The diagnostic performance in clinically significant prostate cancer with PI-RADS version 2.1: simplified bpMRI versus standard mpMRI

Abdom Radiol (NY). 2023 Feb;48(2):704-712. doi: 10.1007/s00261-022-03750-8. Epub 2022 Dec 5.

Authors

Jihui Song^{1

2}, Chenglin Zhao¹, Fei Zhang³, Yingdi Yuan⁴, Lee M Wang⁵, Vivek Sah⁶, Jun Zhang⁷, Wencai Weng², Zhenghan Yang¹, Zhenchang Wang¹, Liang Wang⁸

Affiliations

¹ Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
² Department of Radiology, Dalian University Affiliated Xinhua Hospital, No.156 Wansui Street, Shahekou District, Dalian, 116021, Liaoning, China.
³ Department of Radiology, QUFU City People Hospital, No.111 Chunqiu West Road, Qufu, 273100, Shandong, China.
⁴ Department of Radiology, Ganzhou District People's Hospital, No.705 Beihuan Road, Ganzhou District, Zhangye, 734000, Gansu, China.
⁵ Carnegie Mellon University, Pittsburgh, USA.
⁶ ADK Hospital, Sosun Magu, Male, 20070, Maldives.
⁷ Department of Radiology, The First Hospital of Qinhuangdao, No.258 Wenhua Road, Haigang District, Qinhuangdao, 066000, Hebei, China.
⁸ Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China. 1311935212@qq.com.

PMID: 36464756
DOI: 10.1007/s00261-022-03750-8

Abstract

Objectives: To compare the diagnostic performance for the detection of clinically significant prostate cancer (csPCa) between bpMRI with only axial T2WI (simplified bpMRI) and standard-multiparametric MRI (mpMRI).

Methods: A total of 569 patients who underwent mpMRI followed by biopsy or prostatectomy were enrolled in this retrospective study. According to PI-RADS v2.1, three radiologists (A, B, C) from three centers blinded to clinical variables were assigned scores on lesions with simplified bpMRI and then with mpMRI 2 weeks later. Diagnostic performance of simplified bpMRI was compared with mpMRI using histopathology as reference standard.

Results: For all the three radiologists, the diagnostic sensitivity was significantly higher with mpMRI than with simplified bpMRI (P < 0.001 to P = 0.035); and although specificity was also higher with mpMRI than with simplified bpMRI for radiologist B and radiologist C, it was statistically significant only for radiologist B (P = 0.011, P = 0.359, respectively). On the contrary, for radiologist A, specificity was higher with simplified bpMRI than with mpMRI (P = 0.001). The area under the receiver operating characteristic curve (AUC) was significantly higher for mpMRI than for simplified bpMRI except for radiologist A (radiologist A: 0.903 vs 0.913, P = 0.1542; radiologist B: 0.861 vs 0.834 P = 0.0013; and radiologist C: 0.884 vs 0.848, P = 0.0003). Interobserver reliability of PI-RADS v2.1 showed good agreement for both simplified bpMRI (kappa = 0.665) and mpMRI (kappa = 0.739).

Conclusion: Although the detection of csPCa with simplified bpMRI was comparatively lower than that with mpMRI, the diagnostic performance was still high in simplified bpMRI. Our data justify using mpMRI outperforms simplified bpMRI for prostate cancer screening and imply simplified bpMRI as a potential screening tool.

Keywords: Abbreviated protocol; Multiparametric MRI; PI-RADS; Prostate cancer; Screening; Simplified biparametric MRI.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Early Detection of Cancer
Humans
Magnetic Resonance Imaging
Male
Multiparametric Magnetic Resonance Imaging*
Prostate-Specific Antigen
Prostatic Neoplasms* / pathology
Reproducibility of Results
Retrospective Studies

Substances

Prostate-Specific Antigen