PDF(Pubmed)
Abstract：
UNASSIGNED: The Prostate Imaging for Recurrence Reporting (PI-RR) system was recently proposed to assess the local recurrence of prostate cancer (PCa), but its exact performance for the prostate after radiotherapy or radical prostatectomy is difficult to determine. We aimed to evaluate the diagnostic performance and interreader agreement of this system using whole-mount histology of the prostate after androgen deprivation therapy (ADT) as the standard of reference.
UNASSIGNED: In total, 119 patients with PCa post-ADT underwent multiparametric magnetic resonance imaging (mp-MRI) before prostatectomy. Three radiologists analyzed the MRI images independently, scoring imaging findings according to PI-RR. Spearman correlation was performed to assess the relationship between the percentage of sectors with residual cancer and PI-RR score. The diagnostic performance for detection of residual cancer was assessed on a per-sector basis. The chi-squared test was used to compare the cancer detection rate (CDR) among readers. Overall and pairwise interreader agreement in assigning PI-RR categories and residual cancer sectors with a score ≥3 or ≥4 were evaluated with the Cohen kappa coefficient.
UNASSIGNED: Histology revealed 209 sectors with residual cancer. The percentage of pathologically positive sectors increased with the increase in PI-RR score for all readers. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) at a cutoff of score 3 ranged from 74.2% to 83.7%, 86.4% to 92.7%, 51.3% to 64.3%, and 95.4% to 96.9%, respectively, and at a cutoff of score 4, they ranged from 47.4% to 56.5%, 97.9% to 98.6%, 82.5% to 85.3%, and 91.6% to 92.9%, respectively. There was no significant difference among the CDR of readers. In PI-RR categories and detection of residual cancer sectors, overall interreader agreement was moderate for all readers, but agreement was higher between the more experienced readers (moderate to substantial) than between the more and less experienced readers (fair to moderate).
UNASSIGNED: MRI scoring with the PI-RR assessment provided accurate evaluation of PCa after ADT, but readers\' experience influenced interreader agreement and cancer diagnosis.
UNASSIGNED: In total, 119 patients with PCa post-ADT underwent multiparametric magnetic resonance imaging (mp-MRI) before prostatectomy. Three radiologists analyzed the MRI images independently, scoring imaging findings according to PI-RR. Spearman correlation was performed to assess the relationship between the percentage of sectors with residual cancer and PI-RR score. The diagnostic performance for detection of residual cancer was assessed on a per-sector basis. The chi-squared test was used to compare the cancer detection rate (CDR) among readers. Overall and pairwise interreader agreement in assigning PI-RR categories and residual cancer sectors with a score ≥3 or ≥4 were evaluated with the Cohen kappa coefficient.
UNASSIGNED: Histology revealed 209 sectors with residual cancer. The percentage of pathologically positive sectors increased with the increase in PI-RR score for all readers. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) at a cutoff of score 3 ranged from 74.2% to 83.7%, 86.4% to 92.7%, 51.3% to 64.3%, and 95.4% to 96.9%, respectively, and at a cutoff of score 4, they ranged from 47.4% to 56.5%, 97.9% to 98.6%, 82.5% to 85.3%, and 91.6% to 92.9%, respectively. There was no significant difference among the CDR of readers. In PI-RR categories and detection of residual cancer sectors, overall interreader agreement was moderate for all readers, but agreement was higher between the more experienced readers (moderate to substantial) than between the more and less experienced readers (fair to moderate).
UNASSIGNED: MRI scoring with the PI-RR assessment provided accurate evaluation of PCa after ADT, but readers\' experience influenced interreader agreement and cancer diagnosis.
摘要：
■最近提出了用于复发报告的前列腺成像（PI-RR）系统来评估前列腺癌（PCa）的局部复发，但其确切表现为前列腺放疗或根治性前列腺切除术后难以确定。我们旨在使用雄激素剥夺治疗（ADT）后前列腺的整体组织学作为参考标准来评估该系统的诊断性能和读者共识。
■总共，119例ADT后PCa患者在前列腺切除术前接受了多参数磁共振成像（mp-MRI）。三位放射科医生独立分析了MRI图像,根据PI-RR对成像结果进行评分。进行Spearman相关性以评估具有残留癌症的部门百分比与PI-RR评分之间的关系。在每个扇区的基础上评估检测残留癌症的诊断性能。卡方检验用于比较读者之间的癌症检出率（CDR）。使用Cohenkappa系数评估了在分配PI-RR类别和残留癌症部门时的总体和成对互读协议，得分≥3或≥4。
■组织学显示209个部门残留癌症。所有读者的病理阳性部门的百分比随PI-RR得分的增加而增加。敏感性,特异性，阳性预测值(PPV)，和阴性预测值（NPV）在3分的截止范围从74.2%到83.7%，86.4%到92.7%，51.3%至64.3%，和95.4%到96.9%，分别,在4分时，他们的范围从47.4%到56.5%，97.9%到98.6%,82.5%到85.3%，和91.6%到92.9%，分别。读者的CDR之间没有显着差异。在PI-RR类别和残留癌症部门的检测中，对于所有读者来说，总体的读者协议是适度的，但是，更有经验的读者（中等到实质性）之间的一致性高于经验较多和较少的读者（公平到中等）之间的一致性。
■MRI评分与PI-RR评估提供了ADT后PCa的准确评估，但是读者的经验影响了读者的共识和癌症的诊断。
■总共，119例ADT后PCa患者在前列腺切除术前接受了多参数磁共振成像（mp-MRI）。三位放射科医生独立分析了MRI图像,根据PI-RR对成像结果进行评分。进行Spearman相关性以评估具有残留癌症的部门百分比与PI-RR评分之间的关系。在每个扇区的基础上评估检测残留癌症的诊断性能。卡方检验用于比较读者之间的癌症检出率（CDR）。使用Cohenkappa系数评估了在分配PI-RR类别和残留癌症部门时的总体和成对互读协议，得分≥3或≥4。
■组织学显示209个部门残留癌症。所有读者的病理阳性部门的百分比随PI-RR得分的增加而增加。敏感性,特异性，阳性预测值(PPV)，和阴性预测值（NPV）在3分的截止范围从74.2%到83.7%，86.4%到92.7%，51.3%至64.3%，和95.4%到96.9%，分别,在4分时，他们的范围从47.4%到56.5%，97.9%到98.6%,82.5%到85.3%，和91.6%到92.9%，分别。读者的CDR之间没有显着差异。在PI-RR类别和残留癌症部门的检测中，对于所有读者来说，总体的读者协议是适度的，但是，更有经验的读者（中等到实质性）之间的一致性高于经验较多和较少的读者（公平到中等）之间的一致性。
■MRI评分与PI-RR评估提供了ADT后PCa的准确评估，但是读者的经验影响了读者的共识和癌症的诊断。
