Validation of PI-RADS v2 Scores at Various Non-University Radiology Practices
AffiliationThe University of Arizona College of Medicine - Phoenix
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PublisherThe University of Arizona.
DescriptionA Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.
AbstractPurpose: Validate the second version of the Prostate Imaging Reporting and Data System (PIRADSv2) scores in predicting positive in-bore MRI guided targeted prostate biopsy results across different non-university related institutions. Materials and Methods: This was a retrospective review of 147 patients who underwent multiparametric magnetic resonance imaging followed by in-bore MRI guided targeted prostate biopsy from 2014-2018. Lesions were rated according to PI-RADS v2 criteria. Scores were compared to MR-guided biopsy results and pre-biopsy PSA values. Results: Prostate Cancer (PCa) was detected in 54% (80/147) of patients, with more prostate cancer being detected with each increase in PI-RADS scores. Biopsy results with PI-RADS 3, 4, and 5 lesions resulted in PCa in 25.6% (10/39), 58.1% (33/55), and 86.0% (37/43) respectively. Clinically significant PCa (Gleason score ≥7) was detected in 17.9% (7/39), 52.7% (29/55), and 72% (31/43) of cases for PI-RADS 3, 4, and 5 lesions respectively. When PI-RADS scoring/biopsy results were compared across different institutions, there was no difference in the PI-RADS scoring or in positive biopsy rates.. The sensitivity, specificity, PPV, and NPV for PIRADS 3-4 were not statistically different across the institutions for detecting Gleason 7 or greater lesions. Conclusion: Our results agree with prior studies that higher PI-RADS scores are associated with clinically significant PCa and suggest lesions with PI-RADS 3-5 have sufficient evidence to warrant biopsy. Comparison of PI-RADS across different types of non-university practices revealed no difference in scoring/biopsy outcome, suggesting that PI-RADS v2 can be easily applied outside of the university medical center setting.