Abstract：
OBJECTIVE: To explore the topic of Prostate Imaging-Reporting and Data System (PI-RADS) interobserver variability, including a discussion of major sources, mitigation approaches, and future directions.
METHODS: A narrative review of PI-RADS interobserver variability.
RESULTS: PI-RADS was developed in 2012 to set technical standards for prostate magnetic resonance imaging (MRI), reduce interobserver variability at interpretation, and improve diagnostic accuracy in the MRI-directed diagnostic pathway for detection of clinically significant prostate cancer. While PI-RADS has been validated in selected research cohorts with prostate cancer imaging experts, subsequent prospective studies in routine clinical practice demonstrate wide variability in diagnostic performance. Radiologist and biopsy operator experience are the most important contributing drivers of high-quality care among multiple interrelated factors including variability in MRI hardware and technique, image quality, and population and patient-specific factors such as prostate cancer disease prevalence. Iterative improvements in PI-RADS have helped flatten the curve for novice readers and reduce variability. Innovations in image quality reporting, administrative and organisational workflows, and artificial intelligence hold promise in improving variability even further.
CONCLUSIONS: Continued research into PI-RADS is needed to facilitate benchmark creation, reader certification, and independent accreditation, which are systems-level interventions needed to uphold and maintain high-quality prostate MRI across entire populations.
METHODS: A narrative review of PI-RADS interobserver variability.
RESULTS: PI-RADS was developed in 2012 to set technical standards for prostate magnetic resonance imaging (MRI), reduce interobserver variability at interpretation, and improve diagnostic accuracy in the MRI-directed diagnostic pathway for detection of clinically significant prostate cancer. While PI-RADS has been validated in selected research cohorts with prostate cancer imaging experts, subsequent prospective studies in routine clinical practice demonstrate wide variability in diagnostic performance. Radiologist and biopsy operator experience are the most important contributing drivers of high-quality care among multiple interrelated factors including variability in MRI hardware and technique, image quality, and population and patient-specific factors such as prostate cancer disease prevalence. Iterative improvements in PI-RADS have helped flatten the curve for novice readers and reduce variability. Innovations in image quality reporting, administrative and organisational workflows, and artificial intelligence hold promise in improving variability even further.
CONCLUSIONS: Continued research into PI-RADS is needed to facilitate benchmark creation, reader certification, and independent accreditation, which are systems-level interventions needed to uphold and maintain high-quality prostate MRI across entire populations.
摘要：
目的：探讨前列腺成像报告和数据系统（PI-RADS）观察者间变异的主题，包括对主要来源的讨论，缓解方法，和未来的方向。
方法：PI-RADS观察者间变异性的叙述性综述。
结果：PI-RADS于2012年开发，旨在为前列腺磁共振成像（MRI）设定技术标准，在解释时减少观察者间的变异性，并提高MRI定向诊断途径的诊断准确性，以检测临床上有意义的前列腺癌。虽然PI-RADS已在前列腺癌成像专家的选定研究队列中得到验证，随后在常规临床实践中进行的前瞻性研究表明,在诊断性能方面存在很大差异.放射科医师和活检操作者的经验是在多个相互关联的因素中，包括MRI硬件和技术的可变性，图像质量，以及人群和患者特定因素，如前列腺癌疾病患病率。PI-RADS的迭代改进有助于使新手读者的曲线变平并减少变异性。图像质量报告方面的创新，行政和组织工作流程，和人工智能有望进一步改善可变性。
结论：需要对PI-RADS进行持续研究，以促进基准创建，读者认证,和独立认证，这是在整个人群中维持和维持高质量前列腺MRI所需的系统级干预措施。
方法：PI-RADS观察者间变异性的叙述性综述。
结果：PI-RADS于2012年开发，旨在为前列腺磁共振成像（MRI）设定技术标准，在解释时减少观察者间的变异性，并提高MRI定向诊断途径的诊断准确性，以检测临床上有意义的前列腺癌。虽然PI-RADS已在前列腺癌成像专家的选定研究队列中得到验证，随后在常规临床实践中进行的前瞻性研究表明,在诊断性能方面存在很大差异.放射科医师和活检操作者的经验是在多个相互关联的因素中，包括MRI硬件和技术的可变性，图像质量，以及人群和患者特定因素，如前列腺癌疾病患病率。PI-RADS的迭代改进有助于使新手读者的曲线变平并减少变异性。图像质量报告方面的创新，行政和组织工作流程，和人工智能有望进一步改善可变性。
结论：需要对PI-RADS进行持续研究，以促进基准创建，读者认证,和独立认证，这是在整个人群中维持和维持高质量前列腺MRI所需的系统级干预措施。
