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Open Access 01-03-2019 | Prostate Cancer | Pelvis

False positives in PIRADS (V2) 3, 4, and 5 lesions: relationship with reader experience and zonal location

Authors: Tineke T. Stolk, Igle Jan de Jong, Thomas C. Kwee, Henk B. Luiting, Shekar V. K. Mahesh, Benjamin H. J. Doornweerd, Peter-Paul M. Willemse, Derya Yakar

Published in: Abdominal Radiology | Issue 3/2019

Abstract

Purpose

To investigate the effect of reader experience and zonal location on the occurrence of false positives (FPs) in PIRADS (V2) 3, 4, and 5 lesions on multiparametric (MP)-MRI of the prostate.

Materials and methods

This retrospective study included 139 patients who had consecutively undergone an MP-MRI of the prostate in combination with a transrectal ultrasound MRI fusion-guided biopsy between 2014 and 2017. MRI exams were prospectively read by a group of inexperienced radiologists (cohort 1; 54 patients) and an experienced radiologist (cohort 2; 85 patients). Multivariable logistic regression analysis was performed to determine the association of experience of the radiologist and zonal location with a FP reading. FP rates were compared between readings by inexperienced and experienced radiologists according to zonal location, using Chi-square (χ²) tests.

Results

A total of 168 lesions in 139 patients were detected. Median patient age was 68 years (Interquartile range (IQR) 62.5–73), and median PSA was 10.9 ng/mL (IQR 7.6–15.9) for the entire patient cohort. According to multivariable logistic regression, inexperience of the radiologist was significantly (P = 0.044, odds ratio 1.927, 95% confidence interval [CI] 1.017–3.651) and independently associated with a FP reading, while zonal location was not (P = 0.202, odds ratio 1.444, 95% CI 0.820–2.539). In the transition zone (TZ), the FP rate of the inexperienced radiologists 59% (17/29) was significantly higher (χ²P = 0.033) than that of the experienced radiologist 33% (13/40).

Conclusion

Inexperience of the radiologist is significantly and independently associated with a FP reading, while zonal location is not. Inexperienced radiologists have a significantly higher FP rate in the TZ.

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Title: False positives in PIRADS (V2) 3, 4, and 5 lesions: relationship with reader experience and zonal location
Authors: Tineke T. Stolk
Igle Jan de Jong
Thomas C. Kwee
Henk B. Luiting
Shekar V. K. Mahesh
Benjamin H. J. Doornweerd
Peter-Paul M. Willemse
Derya Yakar
Publication date: 01-03-2019
Publisher: Springer US
Keywords: Prostate Cancer
Prostatitis
Prostate Cancer
Published in: Abdominal Radiology / Issue 3/2019
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI: https://doi.org/10.1007/s00261-019-01919-2

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False positives in PIRADS (V2) 3, 4, and 5 lesions: relationship with reader experience and zonal location

Abstract

Purpose

Materials and methods

Results

Conclusion

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