The performance of PI-RADSv2 and quantitative apparent diffusion coefficient for predicting confirmatory prostate biopsy findings in patients considered for active surveillance of prostate cancer Journal Article


Authors: Nougaret, S.; Robertson, N.; Golia Pernicka, J.; Molinari, N.; Hötker, A. M.; Ehdaie, B.; Sala, E.; Hricak, H.; Vargas, H. A.
Article Title: The performance of PI-RADSv2 and quantitative apparent diffusion coefficient for predicting confirmatory prostate biopsy findings in patients considered for active surveillance of prostate cancer
Abstract: Purpose: To assess the performance of the updated Prostate Imaging Reporting and Data System (PI-RADSv2) and the apparent diffusion coefficient (ADC) for predicting confirmatory biopsy results in patients considered for active surveillance of prostate cancer (PCA). Methods: IRB-approved, retrospective study of 371 consecutive men with clinically low-risk PCA (initial biopsy Gleason score ≤6, prostate-specific antigen <10 ng/ml, clinical stage ≤T2a) who underwent 3T-prostate MRI before confirmatory biopsy. Two independent radiologists recorded the PI-RADSv2 scores and measured the corresponding ADC values in each patient. A composite score was generated to assess the performance of combining PI-RADSv2 + ADC. Results: PCA was upgraded on confirmatory biopsy in 107/371 (29%) patients. Inter-reader agreement was substantial (PI-RADSv2: k = 0.73; 95% CI [0.66–0.80]; ADC: r = 0.74; 95% CI [0.69–0.79]). Accuracies, sensitivities, specificities, positive predicted value and negative predicted value of PI-RADSv2 were 85, 89, 83, 68, 95 and 78, 82, 76, 58, 91% for ADC. PI-RADSv2 accuracy was significantly higher than that of ADC for predicting biopsy upgrade (p = 0.014). The combined PI-RADSv2 + ADC composite score did not perform better than PI-RADSv2 alone. Obviating biopsy in patients with PI-RADSv2 score ≤3 would have missed Gleason Score upgrade in 12/232 (5%) of patients. Conclusion: PI-RADSv2 was superior to ADC measurements for predicting PCA upgrading on confirmatory biopsy. © 2017, Springer Science+Business Media New York.
Keywords: biopsy; prostate; cancer; confirmatory; pi-radsv2
Journal Title: Abdominal Radiology
Volume: 42
Issue: 7
ISSN: 2366-004X
Publisher: Springer  
Date Published: 2017-07-01
Start Page: 1968
End Page: 1974
Language: English
DOI: 10.1007/s00261-017-1086-7
PROVIDER: scopus
PUBMED: 28258355
PMCID: PMC5537601
DOI/URL:
Notes: Article -- Export Date: 1 August 2017 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Evis Sala
    95 Sala
  2. Behfar Ehdaie
    75 Ehdaie
  3. Hedvig Hricak
    333 Hricak
  4. Andreas Markus Hoetker
    21 Hoetker