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Assessment of DCE Utility for PCa Diagnosis Using PI-RADS v2.1: Effects on Diagnostic Accuracy and Reproducibility

1
IRCCS SDN, 80143 Napoli, Italy
2
Ospedale S. Maria delle Grazie, 80078 Pozzuoli, Italy
*
Author to whom correspondence should be addressed.
Diagnostics 2020, 10(3), 164; https://doi.org/10.3390/diagnostics10030164
Received: 20 February 2020 / Revised: 11 March 2020 / Accepted: 16 March 2020 / Published: 17 March 2020
(This article belongs to the Section Medical Imaging)
The role of dynamic contrast-enhanced-MRI (DCE-MRI) for Prostate Imaging-Reporting and Data System (PI-RADS) scoring is a controversial topic. In this retrospective study, we aimed to measure the added value of DCE-MRI in combination with T2-weighted (T2W) and diffusion-weighted imaging (DWI) using PI-RADS v2.1, in terms of reproducibility and diagnostic accuracy, for detection of prostate cancer (PCa) and clinically significant PCa (CS-PCa, for Gleason Score ≥ 7). 117 lesions in 111 patients were identified as suspicion by multiparametric MRI (mpMRI) and addressed for biopsy. Three experienced readers independently assessed PI-RADS score, first using biparametric MRI (bpMRI, including DWI and T2W), and then multiparametric MRI (also including DCE). The inter-rater and inter-method agreement (bpMRI- vs. mpMRI-based scores) were assessed by Cohen’s kappa (κ). Receiver operating characteristics (ROC) analysis was performed to evaluate the diagnostic accuracy for PCa and CS-PCa detection among the two scores. Inter-rater agreement was excellent for the three pairs of readers (κ ≥ 0.83), while the inter-method agreement was good (κ ≥ 0.73). Areas under the ROC curve (AUC) showed similar high-values (0.8 ≤ AUC ≤ 0.85). The reproducibility of PI-RADS v2.1 scoring was comparable and high among readers, without relevant differences, depending on the MRI protocol used. The inclusion of DCE did not influence the diagnostic accuracy. View Full-Text
Keywords: magnetic resonance imaging; prostate cancer; mpMRI; PI-RADS; DCE; reproducibility; ROC analysis magnetic resonance imaging; prostate cancer; mpMRI; PI-RADS; DCE; reproducibility; ROC analysis
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MDPI and ACS Style

Brancato, V.; Di Costanzo, G.; Basso, L.; Tramontano, L.; Puglia, M.; Ragozzino, A.; Cavaliere, C. Assessment of DCE Utility for PCa Diagnosis Using PI-RADS v2.1: Effects on Diagnostic Accuracy and Reproducibility. Diagnostics 2020, 10, 164.

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