Anwar R Padhani1, Jeffrey Weinreb2, Andrew B Rosenkrantz3, Geert Villeirs4, Baris Turkbey5, Jelle Barentsz6. 1. Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, UK. 2. Department of Radiology, Yale University School of Medicine, New Haven, USA. 3. Department of Radiology, NYU Langone Medical Center, New York, USA. 4. Department of Radiology, Ghent University Hospital, Gent, Belgium. 5. Molecular Imaging Program NCI, Bethesda, USA. 6. Radboudumc, Nijmegen, The Netherlands. Electronic address: jelle.barentsz@radboudumc.nl.
Abstract
CONTEXT: The Prostate Imaging-Reporting and Data System (PI-RADS) v2 analysis system for multiparametric magnetic resonance imaging (mpMRI) detection of prostate cancer (PCa) is based on PI-RADS v1, accumulated scientific evidence, and expert consensus opinion. OBJECTIVE: To summarize the accuracy, strengths and weaknesses of PI-RADS v2, discuss pathway implications of its use and outline opportunities for improvements and future developments. EVIDENCE ACQUISITION: For this consensus expert opinion from the PI-RADS steering committee, clinical studies, systematic reviews, and professional guidelines for mpMRI PCa detection were evaluated. We focused on the performance characteristics of PI-RADS v2, comparing data to systems based on clinicoradiologic Likert scales and non-PI-RADS v2 imaging only. Evidence selections were based on high-quality, prospective, histologically verified data, with minimal patient selection and verifications biases. EVIDENCE SYNTHESIS: It has been shown that the test performance of PI-RADS v2 in research and clinical practice retains higher accuracy over systematic transrectal ultrasound (TRUS) biopsies for PCa diagnosis. PI-RADS v2 fails to detect all cancers but does detect the majority of tumors capable of causing patient harm, which should not be missed. Test performance depends on the definition and prevalence of clinically significant disease. Good performance can be attained in practice when the quality of the diagnostic process can be assured, together with joint working of robustly trained radiologists and urologists, conducting biopsy procedures within multidisciplinary teams. CONCLUSIONS: It has been shown that the test performance of PI-RADS v2 in research and clinical practice is improved, retaining higher accuracy over systematic TRUS biopsies for PCa diagnosis. PATIENT SUMMARY: Multiparametric magnetic resonance imaging (MRI) and MRI-directed biopsies using the Prostate Imaging-Reporting and Data System improves the detection of prostate cancers likely to cause harm, and at the same time decreases the detection of disease that does not lead to harms if left untreated. The keys to success are high-quality imaging, reporting, and biopsies by radiologists and urologists working together in multidisciplinary teams.
CONTEXT: The Prostate Imaging-Reporting and Data System (PI-RADS) v2 analysis system for multiparametric magnetic resonance imaging (mpMRI) detection of prostate cancer (PCa) is based on PI-RADS v1, accumulated scientific evidence, and expert consensus opinion. OBJECTIVE: To summarize the accuracy, strengths and weaknesses of PI-RADS v2, discuss pathway implications of its use and outline opportunities for improvements and future developments. EVIDENCE ACQUISITION: For this consensus expert opinion from the PI-RADS steering committee, clinical studies, systematic reviews, and professional guidelines for mpMRI PCa detection were evaluated. We focused on the performance characteristics of PI-RADS v2, comparing data to systems based on clinicoradiologic Likert scales and non-PI-RADS v2 imaging only. Evidence selections were based on high-quality, prospective, histologically verified data, with minimal patient selection and verifications biases. EVIDENCE SYNTHESIS: It has been shown that the test performance of PI-RADS v2 in research and clinical practice retains higher accuracy over systematic transrectal ultrasound (TRUS) biopsies for PCa diagnosis. PI-RADS v2 fails to detect all cancers but does detect the majority of tumors capable of causing patient harm, which should not be missed. Test performance depends on the definition and prevalence of clinically significant disease. Good performance can be attained in practice when the quality of the diagnostic process can be assured, together with joint working of robustly trained radiologists and urologists, conducting biopsy procedures within multidisciplinary teams. CONCLUSIONS: It has been shown that the test performance of PI-RADS v2 in research and clinical practice is improved, retaining higher accuracy over systematic TRUS biopsies for PCa diagnosis. PATIENT SUMMARY: Multiparametric magnetic resonance imaging (MRI) and MRI-directed biopsies using the Prostate Imaging-Reporting and Data System improves the detection of prostate cancers likely to cause harm, and at the same time decreases the detection of disease that does not lead to harms if left untreated. The keys to success are high-quality imaging, reporting, and biopsies by radiologists and urologists working together in multidisciplinary teams.
Authors: Matthew D Greer; Anna M Brown; Joanna H Shih; Ronald M Summers; Jamie Marko; Yan Mee Law; Sandeep Sankineni; Arvin K George; Maria J Merino; Peter A Pinto; Peter L Choyke; Baris Turkbey Journal: J Magn Reson Imaging Date: 2016-07-08 Impact factor: 4.813
Authors: Nicolas Barry Delongchamps; Mathieu Rouanne; Thierry Flam; Frédéric Beuvon; Mathieu Liberatore; Marc Zerbib; François Cornud Journal: BJU Int Date: 2010-11-02 Impact factor: 5.588
Authors: Andrew B Rosenkrantz; Luke A Ginocchio; Daniel Cornfeld; Adam T Froemming; Rajan T Gupta; Baris Turkbey; Antonio C Westphalen; James S Babb; Daniel J Margolis Journal: Radiology Date: 2016-04-01 Impact factor: 11.105
Authors: Daniel P Petrylak; Nicholas J Vogelzang; Nikolay Budnik; Pawel Jan Wiechno; Cora N Sternberg; Kevin Doner; Joaquim Bellmunt; John M Burke; Maria Ochoa de Olza; Ananya Choudhury; Juergen E Gschwend; Evgeny Kopyltsov; Aude Flechon; Nicolas Van As; Nadine Houede; Debora Barton; Abderrahim Fandi; Ulf Jungnelius; Shaoyi Li; Ronald de Wit; Karim Fizazi Journal: Lancet Oncol Date: 2015-03-03 Impact factor: 41.316
Authors: G Mowatt; G Scotland; C Boachie; M Cruickshank; J A Ford; C Fraser; L Kurban; T B Lam; A R Padhani; J Royle; T W Scheenen; E Tassie Journal: Health Technol Assess Date: 2013-05 Impact factor: 4.014
Authors: Caroline M Moore; Francesco Giganti; Peter Albertsen; Clare Allen; Chris Bangma; Alberto Briganti; Peter Carroll; Masoom Haider; Veeru Kasivisvanathan; Alex Kirkham; Laurence Klotz; Adil Ouzzane; Anwar R Padhani; Valeria Panebianco; Peter Pinto; Philippe Puech; Antti Rannikko; Raphaele Renard-Penna; Karim Touijer; Baris Turkbey; Heinrik van Poppel; Riccardo Valdagni; Jochen Walz; Ivo Schoots Journal: Eur Urol Date: 2016-06-24 Impact factor: 20.096
Authors: Michelle Bardis; Roozbeh Houshyar; Chanon Chantaduly; Karen Tran-Harding; Alexander Ushinsky; Chantal Chahine; Mark Rupasinghe; Daniel Chow; Peter Chang Journal: Radiol Imaging Cancer Date: 2021-05
Authors: Anwar R Padhani; Jelle Barentsz; Geert Villeirs; Andrew B Rosenkrantz; Daniel J Margolis; Baris Turkbey; Harriet C Thoeny; François Cornud; Masoom A Haider; Katarzyna J Macura; Clare M Tempany; Sadhna Verma; Jeffrey C Weinreb Journal: Radiology Date: 2019-06-11 Impact factor: 11.105
Authors: Frank-Jan H Drost; Daniël F Osses; Daan Nieboer; Ewout W Steyerberg; Chris H Bangma; Monique J Roobol; Ivo G Schoots Journal: Cochrane Database Syst Rev Date: 2019-04-25
Authors: David Eldred-Evans; Henry Tam; Heminder Sokhi; Anwar R Padhani; Mathias Winkler; Hashim U Ahmed Journal: Nat Rev Urol Date: 2020-07-21 Impact factor: 14.432