TY - JOUR
T1 - Accuracy of Prostate Magnetic Resonance Imaging
T2 - Reader Experience Matters
AU - Kang, Hyunseon C.
AU - Jo, Nahyun
AU - Bamashmos, Anas Saeed
AU - Ahmed, Mona
AU - Sun, Jia
AU - Ward, John F.
AU - Choi, Haesun
N1 - Funding Information:
Funding/Support and role of the sponsor: This research was supported in part by the NIH/NCI under award number P30CA016672 and used the CCSG Biostatistics Resource Group at MD Anderson Cancer Center.
Publisher Copyright:
© 2021 The Authors
PY - 2021/5
Y1 - 2021/5
N2 - Background: Prostate magnetic resonance imaging (MRI) is increasingly used in the detection, image-guided biopsy, and active surveillance of prostate cancer. The accuracy of prostate MRI may differ based on factors including imaging technique, patient population, and reader experience. Objective: To determine whether the accuracy of prostate MRI varies with reader experience. Design, setting, and participants: We rescored regions of interest from 194 consecutive patients who had undergone MRI/ultrasonography fusion biopsy. Original prostate MRI scans had been interpreted by one of 33 abdominal radiologists (AR group). More than 14 mo later, rescoring was performed by two blinded, prostate MRI radiologists (PR group). Likert scoring was used for both original MRI reports and rescoring. Outcome measurements and statistical analysis: Test performance (sensitivity, specificity, positive predictive value [PPV], and negative predictive value [NPV]) of prostate MRI was defined for the AR and PR groups. A Likert score of 4–5 was considered test positive and clinically significant prostate carcinoma (csPCa; Gleason grade group [GGG] ≥2) was considered outcome positive. Results and limitations: MRI-positive lesions (Likert 4–5) scored by the PR group resulted in csPCa more frequently than those scored by the AR group (64.9% vs 39.3%). MRI-negative lesions (Likert 2–3) were more likely to result in a clinically insignificant biopsy (benign pathology or GGG 1) when scored by the PR versus the AR group (91.8% vs 76.6%). Sensitivity and specificity of MRI to detect csPCa were higher for the PR group than for the AR group (sensitivity 85.9% vs 70.7%; specificity 77.3% vs 46.8%). Overall diagnostic accuracy was higher for the PR group than for the AR group (80.1% vs 54.6%). Conclusions: Sensitivity, specificity, PPV, and NPV of prostate MRI were higher for the PR group than for the AR group. Patient summary: We examined the accuracy of prostate magnetic resonance imaging (MRI) in two groups of radiologists. Experienced radiologists were more likely to detect clinically significant prostate cancer on MRI.
AB - Background: Prostate magnetic resonance imaging (MRI) is increasingly used in the detection, image-guided biopsy, and active surveillance of prostate cancer. The accuracy of prostate MRI may differ based on factors including imaging technique, patient population, and reader experience. Objective: To determine whether the accuracy of prostate MRI varies with reader experience. Design, setting, and participants: We rescored regions of interest from 194 consecutive patients who had undergone MRI/ultrasonography fusion biopsy. Original prostate MRI scans had been interpreted by one of 33 abdominal radiologists (AR group). More than 14 mo later, rescoring was performed by two blinded, prostate MRI radiologists (PR group). Likert scoring was used for both original MRI reports and rescoring. Outcome measurements and statistical analysis: Test performance (sensitivity, specificity, positive predictive value [PPV], and negative predictive value [NPV]) of prostate MRI was defined for the AR and PR groups. A Likert score of 4–5 was considered test positive and clinically significant prostate carcinoma (csPCa; Gleason grade group [GGG] ≥2) was considered outcome positive. Results and limitations: MRI-positive lesions (Likert 4–5) scored by the PR group resulted in csPCa more frequently than those scored by the AR group (64.9% vs 39.3%). MRI-negative lesions (Likert 2–3) were more likely to result in a clinically insignificant biopsy (benign pathology or GGG 1) when scored by the PR versus the AR group (91.8% vs 76.6%). Sensitivity and specificity of MRI to detect csPCa were higher for the PR group than for the AR group (sensitivity 85.9% vs 70.7%; specificity 77.3% vs 46.8%). Overall diagnostic accuracy was higher for the PR group than for the AR group (80.1% vs 54.6%). Conclusions: Sensitivity, specificity, PPV, and NPV of prostate MRI were higher for the PR group than for the AR group. Patient summary: We examined the accuracy of prostate magnetic resonance imaging (MRI) in two groups of radiologists. Experienced radiologists were more likely to detect clinically significant prostate cancer on MRI.
KW - Likert scoring system
KW - Magnetic resonance imaging/ultrasonography fusion biopsy
KW - Prostate cancer
KW - Prostate magnetic resonance imaging
KW - Reader experience, Double read
UR - http://www.scopus.com/inward/record.url?scp=85102893189&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85102893189&partnerID=8YFLogxK
U2 - 10.1016/j.euros.2021.03.004
DO - 10.1016/j.euros.2021.03.004
M3 - Article
C2 - 33899028
AN - SCOPUS:85102893189
SN - 2666-1691
VL - 27
SP - 53
EP - 60
JO - European Urology Open Science
JF - European Urology Open Science
ER -