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:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85014296046&doi=10.1007%2fs00261-017-1086-7&partnerID=40&md5=e2ef8bf804774f34c40a6ce0c4a14439
Notes:	Article -- Export Date: 1 August 2017 -- Source: Scopus