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

doi:10.1016/j.ajur.2021.08.002

Asian Journal of Urology, 2023, 10 (4): 488-493 doi: 10.1016/j.ajur.2021.08.002

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

Thomas Whish-Wilson^a,b,*(

),Jo-Lynn Tan^a,William Cross^c,Lih-Ming Wong^a,b,Tom Sutherland^c,d

^aDepartment of Surgery, St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy VIC, Australia
^bDepartment of Surgery, The University of Melbourne, Melbourne VIC, Australia
^cFaculty of Medicine, The University of Melbourne, Melbourne VIC, Australia
^dMedical Imaging Department, St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy VIC, Australia

Abstract
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Abstract

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.

Key words： Prostate cancer Magnetic resonance imaging Prostate Imaging-Reporting and Data System Intrareader Prostate biopsy

Received: 04 January 2021 Available online: 20 October 2023

Corresponding Authors: *Department of Surgery, St Vincent’s Hospital Melbourne, 41 Victoria Pde, Fitzroy VIC, Australia. E-mail address: thomas.whish-wilson@svha.org.au (T. Whish-Wilson).

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Thomas Whish-Wilson,Jo-Lynn Tan,William Cross, et al. Prostate magnetic resonance imaging and the value of experience: An intrareader variability study[J]. Asian Journal of Urology, 2023, 10(4): 488-493.

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http://www.ajurology.com/EN/10.1016/j.ajur.2021.08.002 OR http://www.ajurology.com/EN/Y2023/V10/I4/488

Patient demographics (n=96).

Number of lesions detected on original versus re-read.

The accuracy in magnetic resonance imaging reporting.

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