Correlation of 3T multiparametric prostate MRI using prostate imaging reporting and data system (PIRADS) version 2 with biopsy as reference standard
To correlate the findings on 3T multiparametric prostate MRI using PIRADS version 2 with prostate biopsy results as the standard of reference.
Materials and methods
134 consecutive treatment naive patients (mean age 64 years, range 41–82 years) underwent MRI-directed prostate biopsy. MRI–TRUS fusion biopsy was used for 77 (77/134 = 57.5%) patients, cognitive fusion for 51 (51/134 = 38.0%) patients, and 6 patients (6/134 = 4.5%) without a target nodule had systematic biopsy only. Out of the 1676 biopsy sites, 237 (237/1676 = 14.1%) were positive on MRI for a PIRADS 3, 4, or 5 nodule. Fifty-eight (58/134, 43.3%) patients had clinically significant prostate cancer (csPCa). The findings on MRI using PIRADS version 2 were correlated with the biopsy results.
The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of PIRADS ≥ 3 for csPCa were 89%, 76.5%, 89.7%, 31.7%, and 98.4%, respectively. The detection rates of csPCa for PIRADS 3, 4, and 5 nodules were 6.1% (4/66), 33.3% (42/126), and 64.4% (29/45), respectively. MRI did not identify a nodule in 23/1676 (1.4%) biopsy sites that contained csPCa. The MRI reader, biopsy operator, method of fusion biopsy, and zonal location of prostate nodule did not significantly affect the odds of having a biopsy result positive for csPCa.
PIRADS ≥ 3 had high specificity and high negative predictive value for csPCa using biopsy results as the standard of reference. The presence of csPCa from a biopsy site was highly unlikely in the absence of a corresponding PIRADS ≥ 3 nodule.
KeywordsProstate MRI PI-RADS Prostate biopsy Prostate cancer
SM: Conceptualization, methodology, data acquisition/analysis, literature review, investigation, validation, writing. MEO and AT: Conceptualization, methodology, data acquisition, clinical studies, literature review, investigation, validation, writing, administration, supervision. SG, KJ, MM, and BS: Conceptualization, methodology, clinical studies, literature review, investigation, validation, writing. LZ: Methodology, literature review, literature review, investigation, data analysis, writing. HM: Conceptualization, methodology, data acquisition/analysis, literature review, investigation, writing.
Compliance with ethical standards
Conflict of interest
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
Waived by institutional Research Ethics Board for this retrospective study.
- 4.American College of Radiology (2015) MR prostate imaging reporting and data system version 2.0. ACR WebpageGoogle Scholar
- 13.Martin PR, Cool DW, Romagnoli C, Fenster A, Ward AD (2014) Magnetic resonance imaging-targeted, 3D transrectal ultrasound-guided fusion biopsy for prostate cancer: quantifying the impact of needle delivery error on diagnosis. Med Phys 41:73504. https://doi.org/10.1118/1.4883838 CrossRefGoogle Scholar
- 14.Purysko AS, Bittencourt LK, Bullen JA, et al. (2017) Accuracy and interobserver agreement for prostate imaging reporting and data system, version 2, for the characterization of lesions identified on multiparametric MRI of the prostate. Am J Roentgenol 2:1–7. https://doi.org/10.2214/AJR.16.17289 Google Scholar
- 25.Wysock JS, Rosenkrantz AB, Huang WC, et al. (2014) A prospective, blinded comparison of magnetic resonance (MR) imaging-ultrasound fusion and visual estimation in the performance of MR-targeted prostate biopsy: the profus trial. Eur Urol 66:343–351. https://doi.org/10.1016/j.eururo.2013.10.048 CrossRefGoogle Scholar