Prostate magnetic resonance imaging and the value of experience: An intrareader variability study

Objective: To measure the intraobserver concordance of an experienced genitourinary radiologist reporting of multiparametric magnetic resonance imaging of the prostate (mpMRIp) scans over time. Methods: An experienced genitourinary radiologist re-reported his original 100 consecutive mpMRIp scans us...

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Main Authors: Thomas Whish-Wilson, Jo-Lynn Tan, William Cross, Lih-Ming Wong, Tom Sutherland
Format: Article
Language:English
Published: Elsevier 2023-10-01
Series:Asian Journal of Urology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2214388221000771
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author Thomas Whish-Wilson
Jo-Lynn Tan
William Cross
Lih-Ming Wong
Tom Sutherland
author_facet Thomas Whish-Wilson
Jo-Lynn Tan
William Cross
Lih-Ming Wong
Tom Sutherland
author_sort Thomas Whish-Wilson
collection DOAJ
description Objective: To measure the intraobserver concordance of an experienced genitourinary radiologist reporting of multiparametric magnetic resonance imaging of the prostate (mpMRIp) scans over time. Methods: An experienced genitourinary radiologist re-reported his original 100 consecutive mpMRIp scans using Prostate Imaging-Reporting and Data System version 2 (PI-RADS v2) after 5 years of further experience comprising >1000 scans. Intraobserver agreement was measured using Cohen's kappa. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy were calculated, and comparison of sensitivity was performed using McNemar's test. Results: Ninety-six mpMRIp scans were included in our final analysis. Of the 96 patients, 53 (55.2%) patients underwent subsequent biopsy (n=43) or prostatectomy (n=15), with 73 lesions targeted. Moderate agreement (Cohen's kappa 0.55) was seen in the number of lesions identified at initial reporting and on re-reading (81 vs. 39 total lesions; and 71 vs. 37 number of PI-RADS ≥3 lesions). For clinically significant prostate cancer, re-reading demonstrated an increase in specificity (from 43% to 89%) and PPV (from 62% to 87%), but a decrease in sensitivity (from 94% to 72%, p=0.01) and NPV (from 89% to 77%). Conclusion: The intraobserver agreement for a novice to experienced radiologist reporting mpMRIp using PI-RADS v2 is moderate. Reduced sensitivity is off-set by improved specificity and PPV, which validate mpMRIp as a gold standard for prebiopsy screening.
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spelling doaj-art-7bd1fc7d78bf4d7ea9b8b9fae34832402025-08-20T03:35:44ZengElsevierAsian Journal of Urology2214-38822023-10-0110448849310.1016/j.ajur.2021.08.002Prostate magnetic resonance imaging and the value of experience: An intrareader variability studyThomas Whish-Wilson0Jo-Lynn Tan1William Cross2Lih-Ming Wong3Tom Sutherland4Department of Surgery, St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy VIC, Australia; Department of Surgery, The University of Melbourne, Melbourne VIC, Australia; Corresponding author. Department of Surgery, St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy VIC, Australia.Department of Surgery, St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy VIC, AustraliaFaculty of Medicine, The University of Melbourne, Melbourne VIC, AustraliaDepartment of Surgery, St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy VIC, Australia; Department of Surgery, The University of Melbourne, Melbourne VIC, AustraliaFaculty of Medicine, The University of Melbourne, Melbourne VIC, Australia; Medical Imaging Department, St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy VIC, AustraliaObjective: To measure the intraobserver concordance of an experienced genitourinary radiologist reporting of multiparametric magnetic resonance imaging of the prostate (mpMRIp) scans over time. Methods: An experienced genitourinary radiologist re-reported his original 100 consecutive mpMRIp scans using Prostate Imaging-Reporting and Data System version 2 (PI-RADS v2) after 5 years of further experience comprising >1000 scans. Intraobserver agreement was measured using Cohen's kappa. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy were calculated, and comparison of sensitivity was performed using McNemar's test. Results: Ninety-six mpMRIp scans were included in our final analysis. Of the 96 patients, 53 (55.2%) patients underwent subsequent biopsy (n=43) or prostatectomy (n=15), with 73 lesions targeted. Moderate agreement (Cohen's kappa 0.55) was seen in the number of lesions identified at initial reporting and on re-reading (81 vs. 39 total lesions; and 71 vs. 37 number of PI-RADS ≥3 lesions). For clinically significant prostate cancer, re-reading demonstrated an increase in specificity (from 43% to 89%) and PPV (from 62% to 87%), but a decrease in sensitivity (from 94% to 72%, p=0.01) and NPV (from 89% to 77%). Conclusion: The intraobserver agreement for a novice to experienced radiologist reporting mpMRIp using PI-RADS v2 is moderate. Reduced sensitivity is off-set by improved specificity and PPV, which validate mpMRIp as a gold standard for prebiopsy screening.http://www.sciencedirect.com/science/article/pii/S2214388221000771Prostate cancerMagnetic resonance imagingProstate Imaging-Reporting and Data SystemIntrareaderProstate biopsy
spellingShingle Thomas Whish-Wilson
Jo-Lynn Tan
William Cross
Lih-Ming Wong
Tom Sutherland
Prostate magnetic resonance imaging and the value of experience: An intrareader variability study
Asian Journal of Urology
Prostate cancer
Magnetic resonance imaging
Prostate Imaging-Reporting and Data System
Intrareader
Prostate biopsy
title Prostate magnetic resonance imaging and the value of experience: An intrareader variability study
title_full Prostate magnetic resonance imaging and the value of experience: An intrareader variability study
title_fullStr Prostate magnetic resonance imaging and the value of experience: An intrareader variability study
title_full_unstemmed Prostate magnetic resonance imaging and the value of experience: An intrareader variability study
title_short Prostate magnetic resonance imaging and the value of experience: An intrareader variability study
title_sort prostate magnetic resonance imaging and the value of experience an intrareader variability study
topic Prostate cancer
Magnetic resonance imaging
Prostate Imaging-Reporting and Data System
Intrareader
Prostate biopsy
url http://www.sciencedirect.com/science/article/pii/S2214388221000771
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