Keywords:
Genital / Reproductive system male, Pelvis, MR, MR-Diffusion/Perfusion, MR-Spectroscopy, Observer performance, Outcomes analysis, Structured reporting, Cancer
Authors:
D. Gutierrez, O. Chirife, C. Pineda; Barcelona/ES
DOI:
10.1594/ecr2013/C-0968
Conclusion
The recommended use of MRI in prostate cancer is multiparametric.
The integration of technics such as DWI,
DCE and spectroscopy has been shown to increase the sensibility and specificity of prostate cancer detection [4],
reaching predictive values of up to 80% [6].
We found the PI-RADS score system to be a reliable reporting system for the mpMRI with fairly good interobserver agreement,
with the highest kappa for the T2w image and DCE sequence.
A positive relationship not only between the T2w image and DWI scores,
but also the total score,
and the presence of carcinoma in the targeted biopsies was found.
Is it important to note that the readers,
despite being trained in prostate mpMRI,
are by no means considered experts.
Nonetheless,
the promising results obtained not only in this,
but also in other studies [3] put in evidence the need for a further large-scale prospective validation of the PI-RADS.
Given the current management of prostatic carcinoma,
the gold standard used in our study was the targeted biopsy in all but one patient (who underwent a radical prostatectomy,
confirming the biopsy results),
and in the same manner,
negative biopsies could not be verified for the absence of cancer,
amounting to a classic verification bias.
It would also be beneficial to dispose of a larger sample,
which would probably be needed in order to achieve a significant statistical difference in other PI-RADS subscores.