Prostat kanseri tanısında PI-RADS ve LIKERT skorlama sistemlerinin karşılaştırılması ve radyolog deneyiminin katkısı

Year 2025, Volume: 50 Issue: 1, 106 - 114, 31.03.2025

Ali Can Topaloğlu , Hüseyin Akkaya , Ömer Kaya , Gökhan İpek , Okan Dılek , Selim Özdemir , Bozkurt Gülek , Gökhan Söker

https://doi.org/10.17826/cumj.1608411

Abstract

Amaç: Bu çalışmanın amacı iki skorlama sisteminin histopatolojik verilerle uyumunu ve bu uyum ile radyolog deneyimi arasındaki ilişkiyi araştırmaktır.
Gereç ve Yöntem: Prostat kanseri ön tanısı ile multiparametrik prostat MRG (mpMRI) yapılan toplam 347 hasta retrospektif olarak incelendi. Değerlendiriciler görüntüleri bağımsız olarak PI-RADS v2.1'e göre puanladı. İki hafta sonra, önceki PI-RADS v2.1 puanlarına kör olarak LIKERT sistemini kullanarak görüntüleri bağımsız olarak puanladılar. Her iki skorlama sisteminde de 1, 2 ve 3 skorları benign olarak kabul edilirken, 4 ve 5 skorları malign olarak kabul edilmiştir. Çalışma, bu skorların patoloji sonuçlarıyla korelasyonunu ve okuyucular arası uyumu araştırmıştır.
Bulgular: Hastaların yaş ortalaması 65.5±7.7 yıldı. Her iki skorlama sisteminin referans standart patoloji ile uyumunu değerlendiren kappa analizinde, uyumun radyolog deneyimi ile arttığı gözlendi. Tüm prostat için, PI-RADS v2.1 ile okuyucu 1, 2, 3 ve 4 için kappa değerleri sırasıyla 0.669, 0.669, 0.711 ve 0.771 ve LIKERT sistemi ile sırasıyla 0.589, 0.669, 0.701 ve 0.771 olarak bulundu. Eğri altında kalan alan değerleri PI-RADS için 0,901 (0,893-0,921) ve LIKERT için 0,895 (0,871-0,922) idi.
Sonuç: PI-RADS v2.1 ve LIKERT skorlama sistemleri mpMRI değerlendirmesinde benzer okuyucular arası uyum sağlamıştır. Daha az deneyimli radyologlar arasında PI-RADS v2.1 patoloji ile daha yüksek uyum gösterirken, daha deneyimli radyologlar arasında iki skorlama sistemi arasında fark gözlenmedi.

Keywords

Prostat kanseri, PI-RADS v2.1, LIKERT, Multiparametrik MRG, PSA

Comparison of PI-RADS and LIKERT scoring systems in the diagnosis of prostate cancer and the contribution of radiologist experience

Abstract

Purpose: The aim of this study was to investigate the concordance of these two scoring systems with histopathological data and the relationship between this concordance and radiologist experience.
Materials and Methods: A total of 347 patients who underwent multiparametric prostate MRI (mpMRI) with a preliminary diagnosis of prostate cancer were retrospectively reviewed. The assessors independently scored the images according to PI-RADS v2.1. Two weeks later, they independently scored the images using the LIKERT system while blinded to their previous PI-RADS v2.1 scores. The study investigated the correlation of these scores with the pathology results and the inter-reader agreement.
Results: The mean age of the patients was 65.5±7.7 years. In the kappa analysis, which evaluated the concordance of both scoring systems with the reference standard pathology, it was observed that concordance increased with radiologist experience. For the entire gland, the kappa values for readers 1, 2, 3, and 4 with PI-RADS v2.1 were found to be 0.669, 0.669, 0.711, and 0.771, respectively, and with the LIKERT system, they were 0.589, 0.669, 0.701, and 0.771, respectively. The AUC values were 0.901 (0.893–0.921) for PI-RADS and 0.895 (0.871–0.922) for LIKERT.
Conclusion: The PI-RADS v2.1 and LIKERT scoring systems provided similar inter-reader agreement in evaluating mpMRI. Among less experienced radiologists, PI-RADS v2.1 demonstrated higher concordance with pathology, whereas no difference was observed between more experienced radiologists.

Keywords

Prostate cancer, PI-RADS v2.1, LIKERT, Multiparametric MRI, PSA

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