Top

European Radiology

Published in:

01-11-2013 | Urogenital

Inter-reader agreement of the ESUR score for prostate MRI using in-bore MRI-guided biopsies as the reference standard

Authors: L. Schimmöller, M. Quentin, C. Arsov, R. S. Lanzman, A. Hiester, R. Rabenalt, G. Antoch, P. Albers, D. Blondin

Published in: European Radiology | Issue 11/2013

Abstract

Objectives

The recent European Society of Urogenital Radiology (ESUR) guidelines for evaluation and reporting of prostate multiparametric magnetic resonance imaging (mp-MRI) include the Prostate Imaging Reporting and Data System (PI-RADS). The aim of this study was to investigate the inter-reader agreement of this scoring system.

Methods

One hundred and sixty-four lesions in 67 consecutive patients with elevated prostate-specific antigen and previously negative trans-rectal ultrasound (TRUS)-guided biopsy were scored retrospectively by three blinded readers using PI-RADS. Mp-MRI was performed at 3 T using T2-weighted, diffusion-weighted and dynamic contrast-enhanced imagings (T2WI, DWI, DCE-MRI). Histology of all lesions was obtained by in-bore MRI-guided biopsy. Cohen’s kappa statistics were calculated for all readers.

Results

Inter-reader agreement for all lesions was good to moderate (T2WI, κ = 0.55; DWI, κ = 0.64; DCE-MRI, κ = 0.65). For tumour lesions it was good (T2WI, κ = 0.66; DWI, κ = 0.80; DCE-MRI, κ = 0.63) and for benign lesions moderate to good (T2WI, κ = 0.46; DWI, κ = 0.52; DCE-MRI, κ = 0.67). Using an overall PI-RADS score with a threshold of ≥10, we achieved a sensitivity of 85.7 %, and negative predictive value of 90.1 % for biopsied lesions.

Conclusion

PI-RADS score shows good to moderate inter-reader agreement and enables standardised evaluation of prostate mp-MRI, with high sensitivity and negative predictive value.

Key Points

• The European Society of Urogenital Radiology recently published guidelines for prostate MRI.

• We have evaluated inter-reader agreement of ESUR scoring for multiparametric prostate MRI.

• PI-RADS shows good to moderate inter-reader agreement and is clinically applicable.

• PI-RADS achieves in our series high sensitivity and negative predictive value for biopsied lesions.

• PI-RADS can be used as standardised scoring system in prostate cancer detection.

Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM (2010) GLOBOCAN 2008 v2.0, cancer incidence and mortality worldwide: IARC CancerBase No. 10. International Agency for Research on Cancer, Lyon, France. Available via http://globocan.iarc.fr. Accessed 15. January 2013

Mistry K, Cable G (2003) Meta-analysis of prostate-specific antigen and digital rectal examination as screening tests for prostate carcinoma. J Am Board Fam Pract 16:95–101PubMedCrossRef

Heidenreich A, Aus G, Bolla M et al (2008) EAU guidelines on prostate cancer. Eur Urol 53:68–80PubMedCrossRef

Dickinson L, Ahmed HU, Allen C et al (2011) Magnetic resonance imaging for the detection, localization and characterisation of prostate cancer: recommendations from a European consensus meeting. Eur Urol 59:477–494PubMedCrossRef

Umbehr M, Bachmann LM, Held U et al (2009) Combined magnetic resonance imaging and magnetic resonance spectroscopy imaging in the diagnosis of prostate cancer: a systematic review and meta-analysis. Eur Urol 55:575–590PubMedCrossRef

Mazaheri Y, Shukla-Dave A, Muellner A et al (2008) MR imaging of the prostate in clinical practice. MAGMA 21:379–392PubMedCrossRef

Hoeks CM, Barentsz JO, Hambrock T et al (2011) Prostate cancer: multi-parametric MR imaging for detection, localization, and staging. Radiology 261:46–66PubMedCrossRef

Heidenreich A, Bellmunt J, Bolla M et al (2011) EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease. Eur Urol 59:61–71PubMedCrossRef

Portalez D, Rollin G, Leandri P et al (2010) Prospective comparison of T2w- MRI and dynamic-contrast-enhanced MRI, 3D-MR spectroscopic imaging or diffusion-weighted MRI in repeat TRUS-guided biopsies. Eur Radiol 20:2781–2790PubMedCrossRef

10.

Hricak H, Choyke PL, Eberhardt SC et al (2007) Imaging prostate cancer: a multidisciplinary perspective. Radiology 243:28–53PubMedCrossRef

11.

Barentsz JO, Richenberg J, Clements R et al (2012) ESUR prostate MR guidelines 2012. Eur Radiol 22:746–757PubMedCrossRef

12.

American College of Radiology (2003) Breast Imaging Reporting and Data System (BI-RADS), Breast Imaging Atlas, 4th edn. American College of Radiology (ACR), Reston

13.

Molleran V, Mahoney MC (2010) The BI-RADS breast magnetic resonance imaging lexicon. Magn Reson Imaging Clin N Am 18:171–185PubMedCrossRef

14.

Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174PubMedCrossRef

15.

“Interdisziplinären Leitlinie der Qualität S3 zur Früherkennung, Diagnose und Therapie der verschiedenen Stadien des Prostatakarzinoms”. Available via http://www.awmf.org/leitlinien/detail/ll/043-022OL.html. Accessed 01. April 2013

16.

Hara N, Okuizumi M, Koike H, Kawaguchi M, Bilim V (2005) Dynamic contrast-enhanced magnetic resonance imaging (DCEMRI) is a useful modality for the precise detection and staging of early prostate cancer. Prostate 62:140–147PubMedCrossRef

17.

Delongchamps NB, Rouanne M, Flam T et al (2011) Multiparametric magnetic resonance imaging for the detection and localization of prostate cancer: combination of T2-weighted, dynamic contrast-enhanced and diffusion-weighted imaging. BJU Int 7:1411–1418CrossRef

18.

Anastasiadis AG, Lichy MP, Nagele U et al (2006) MRI-guided biopsy of the prostate increases diagnostic performance in men with elevated or increasing PSA levels after previous negative TRUS biopsies. Eur Urol 50:738–748PubMedCrossRef

19.

Roethke M, Anastasiadis AG, Lichy M et al (2012) MRI-guided prostate biopsy detects clinically significant cancer: analysis of a cohort of 100 patients after previous negative TRUS biopsy. World J Urol 30:213–218PubMedCrossRef

20.

Franiel T, Stephan C, Erbersdobler A, Dietz E, Maxeiner A et al (2011) Areas suspicious for prostate cancer: MR-guided biopsy in patients with at least one transrectal US-guided biopsy with a negative finding—multiparametric MR imaging for detection and biopsy planning. Radiology 259:162–172PubMedCrossRef

21.

Hambrock T, Somford DM, Hoeks C et al (2010) Magnetic resonance imaging guided prostate biopsy in men with repeat negative biopsies and increased prostate specific antigen. J Urol 183:520–527PubMedCrossRef

22.

Kobus T, Vos PC, Hambrock T, De Rooij M, Hulsbergen-van de Kaa CA, Barentsz JO, Heerschap A, Scheenen TWJ (2012) Prostate cancer aggressiveness: in vivo assessment of MR spectroscopy and diffusion-weighted imaging at 3 T. Radiology 265:457–467PubMedCrossRef

23.

Futterer JJ, Scheenen TW, Heijmink SW et al (2007) Standardized threshold approach using three-dimensional proton magnetic resonance spectroscopic imaging in prostate cancer localization of the entire prostate. Invest Radiol 42:116–122PubMedCrossRef

24.

Arsov C, Quentin M, Rabenalt R, Antoch G, Albers P, Blondin D (2012) Repeat transrectal ultrasound biopsies with additional targeted cores according to results of functional prostate MRI detects high-risk prostate cancer in patients with previous negative biopsy and increased PSA—a pilot study. Anticancer Res 32:1087–1092PubMed

25.

Arsov C, Blondin D, Rabenalt R, Antoch G, Albers P, Quentin M (2012) Standardised scoring of a multi-parametric 3-T MRI for a targeted MRI-guided prostate biopsy. Urologe 51:848–856PubMedCrossRef

26.

Quentin M, Arsov C, Röhlen S et al (2012) Inter-reader agreement of multi-parametric MR imaging for the detection of prostate cancer: evaluation of a scoring system. Röfo 184:925–929PubMed

27.

Kirkham AP, Emberton M, Allen C (2006) How good is MRI at detecting and characterising cancer within the prostate? Eur Urol 50:1163–1174PubMedCrossRef

28.

Choi YJ, Kim JK, Kim N et al (2007) Functional MR imaging of prostate cancer. Radiographics 27:63–75PubMedCrossRef

29.

Bratan F, Niaf E, Melodelima C, Chesnais AL, Souchon R, Mège-Lechevallier F, Colombel M, Rouvière O (2013) Influence of imaging and histological factors on prostate cancer detection and localisation on multiparametric MRI: a prospective study. Eur Radiol. doi:10.1007/s00330-013-2795-0 PubMed

30.

Chesnais AL, Niaf E, Bratan F, Mège-Lechevallier F, Roche S, Rabilloud M, Colombel M, Rouvière O (2013) Differentiation of transitional zone prostate cancer from benign hyperplasia nodules: evaluation of discriminant criteria at multiparametric MRI. Clin Radiol 68:e323–e330PubMedCrossRef

Title: Inter-reader agreement of the ESUR score for prostate MRI using in-bore MRI-guided biopsies as the reference standard
Authors: L. Schimmöller
M. Quentin
C. Arsov
R. S. Lanzman
A. Hiester
R. Rabenalt
G. Antoch
P. Albers
D. Blondin
Publication date: 01-11-2013
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 11/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-013-2922-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Inter-reader agreement of the ESUR score for prostate MRI using in-bore MRI-guided biopsies as the reference standard

Abstract

Objectives

Methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Key Points

Please log in to get access to this content

Other articles of this Issue 11/2013

Evaluation of testicular tumour calcification with digital orchiography

Dynamic contrast-enhanced MR imaging for differentiation between enchondroma and chondrosarcoma

Simultaneous dual-isotope SPECT/CT with 99mTc- and 111In-labelled albumin microspheres in treatment planning for SIRT

Blunt thoracic aortic injuries: CT characterisation and treatment outcomes of minor injury

Mid-term clinical efficacy of a volumetric magnetic resonance-guided high-intensity focused ultrasound technique for treatment of symptomatic uterine fibroids

Detection of left atrial thrombus in patients with mitral stenosis and atrial fibrillation: retrospective comparison of two-phase computed tomography, transoesophageal echocardiography and surgical findings