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Variability of the Positive Predictive Value of PI-RADS for Prostate MRI across 26 Centers: Experience of the Society of Abdominal Radiology Prostate Cancer Disease-focused Panel.

Publication ,  Journal Article
Westphalen, AC; McCulloch, CE; Anaokar, JM; Arora, S; Barashi, NS; Barentsz, JO; Bathala, TK; Bittencourt, LK; Booker, MT; Braxton, VG; Ghai, S ...
Published in: Radiology
July 2020

Background Prostate MRI is used widely in clinical care for guiding tissue sampling, active surveillance, and staging. The Prostate Imaging Reporting and Data System (PI-RADS) helps provide a standardized probabilistic approach for identifying clinically significant prostate cancer. Despite widespread use, the variability in performance of prostate MRI across practices remains unknown. Purpose To estimate the positive predictive value (PPV) of PI-RADS for the detection of high-grade prostate cancer across imaging centers. Materials and Methods This retrospective cross-sectional study was compliant with the HIPAA. Twenty-six centers with members in the Society of Abdominal Radiology Prostate Cancer Disease-focused Panel submitted data from men with suspected or biopsy-proven untreated prostate cancer. MRI scans were obtained between January 2015 and April 2018. This was followed with targeted biopsy. Only men with at least one MRI lesion assigned a PI-RADS score of 2-5 were included. Outcome was prostate cancer with Gleason score (GS) greater than or equal to 3+4 (International Society of Urological Pathology grade group ≥2). A mixed-model logistic regression with institution and individuals as random effects was used to estimate overall PPVs. The variability of observed PPV of PI-RADS across imaging centers was described by using the median and interquartile range. Results The authors evaluated 3449 men (mean age, 65 years ± 8 [standard deviation]) with 5082 lesions. Biopsy results showed 1698 cancers with GS greater than or equal to 3+4 (International Society of Urological Pathology grade group ≥2) in 2082 men. Across all centers, the estimated PPV was 35% (95% confidence interval [CI]: 27%, 43%) for a PI-RADS score greater than or equal to 3 and 49% (95% CI: 40%, 58%) for a PI-RADS score greater than or equal to 4. The interquartile ranges of PPV at these same PI-RADS score thresholds were 27%-44% and 27%-48%, respectively. Conclusion The positive predictive value of the Prostate Imaging and Reporting Data System was low and varied widely across centers. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Milot in this issue.

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Published In

Radiology

DOI

EISSN

1527-1315

Publication Date

July 2020

Volume

296

Issue

1

Start / End Page

76 / 84

Location

United States

Related Subject Headings

  • Societies, Medical
  • Retrospective Studies
  • Reproducibility of Results
  • Radiology Information Systems
  • Prostatic Neoplasms
  • Prostate
  • Predictive Value of Tests
  • Nuclear Medicine & Medical Imaging
  • Male
  • Magnetic Resonance Imaging
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Westphalen, A. C., McCulloch, C. E., Anaokar, J. M., Arora, S., Barashi, N. S., Barentsz, J. O., … Rosenkrantz, A. B. (2020). Variability of the Positive Predictive Value of PI-RADS for Prostate MRI across 26 Centers: Experience of the Society of Abdominal Radiology Prostate Cancer Disease-focused Panel. Radiology, 296(1), 76–84. https://doi.org/10.1148/radiol.2020190646
Westphalen, Antonio C., Charles E. McCulloch, Jordan M. Anaokar, Sandeep Arora, Nimrod S. Barashi, Jelle O. Barentsz, Tharakeswara K. Bathala, et al. “Variability of the Positive Predictive Value of PI-RADS for Prostate MRI across 26 Centers: Experience of the Society of Abdominal Radiology Prostate Cancer Disease-focused Panel.Radiology 296, no. 1 (July 2020): 76–84. https://doi.org/10.1148/radiol.2020190646.
Westphalen, Antonio C., et al. “Variability of the Positive Predictive Value of PI-RADS for Prostate MRI across 26 Centers: Experience of the Society of Abdominal Radiology Prostate Cancer Disease-focused Panel.Radiology, vol. 296, no. 1, July 2020, pp. 76–84. Pubmed, doi:10.1148/radiol.2020190646.
Westphalen AC, McCulloch CE, Anaokar JM, Arora S, Barashi NS, Barentsz JO, Bathala TK, Bittencourt LK, Booker MT, Braxton VG, Carroll PR, Casalino DD, Chang SD, Coakley FV, Dhatt R, Eberhardt SC, Foster BR, Froemming AT, Fütterer JJ, Ganeshan DM, Gertner MR, Mankowski Gettle L, Ghai S, Gupta RT, Hahn ME, Houshyar R, Kim C, Kim CK, Lall C, Margolis DJA, McRae SE, Oto A, Parsons RB, Patel NU, Pinto PA, Polascik TJ, Spilseth B, Starcevich JB, Tammisetti VS, Taneja SS, Turkbey B, Verma S, Ward JF, Warlick CA, Weinberger AR, Yu J, Zagoria RJ, Rosenkrantz AB. Variability of the Positive Predictive Value of PI-RADS for Prostate MRI across 26 Centers: Experience of the Society of Abdominal Radiology Prostate Cancer Disease-focused Panel. Radiology. 2020 Jul;296(1):76–84.

Published In

Radiology

DOI

EISSN

1527-1315

Publication Date

July 2020

Volume

296

Issue

1

Start / End Page

76 / 84

Location

United States

Related Subject Headings

  • Societies, Medical
  • Retrospective Studies
  • Reproducibility of Results
  • Radiology Information Systems
  • Prostatic Neoplasms
  • Prostate
  • Predictive Value of Tests
  • Nuclear Medicine & Medical Imaging
  • Male
  • Magnetic Resonance Imaging