PI-RADS V2 ve V2.1'in Tanısal Performansının ve Her İki Sürümdeki Gözlemciler Arası Uyumun Karşılaştırılması

Year 2024, Volume: 34 Issue: 2, 223 - 229, 30.04.2024

Ahmet Baytok , Mustafa Koplay , Halil Özer , Ömer Faruk Topaloğlu , Mehmet Kaynar , Serdar Göktaş , Ali Furkan Batur

https://doi.org/10.54005/geneltip.1378687

Abstract

Amaç: PI-RADS v2 ile v2.1 'nin klinik olarak anlamlı prostat kanserlerinin saptanmasına yönelik tanısal performansı ve gözlemciler arası uyumunu karşılaştırmak.
Gereç ve Yöntem: Bu retrospektif çalışmaya dahil edilen 258 hasta ve 394 nodülün mpMRI görüntüleri 3T MR'da elde edilmiş ve iki radyolog tarafından PI-RADS v2 ve v2.1'e göre değerlendirildi. V2 ve v2.1 arasındaki duyarlılık ve özgüllük karşılaştırıldı. V2'den v2.1'in kullanımında yükseltilmiş ve indirgenmiş lezyonlarda klinik olarak anlamlı prostat kanserlerinin tespit oranları değerlendirildi. Gözlemciler arası uyum κ istatistikleri kullanılarak değerlendirildi.
Bulgular: PI-RADS v2.1 ve v2, csPCA tespitinde kategori ≥4 lezyonlar için periferik zonda yüksek duyarlılık ve düşük özgüllük (%100, %52,38) ve transizyonel zonda yüksek duyarlılık ve özgüllük (%92,86, %98,79) gösterdi, iki versiyon arasında anlamlı bir fark bulunamadı. Her iki sınıflandırmaya göre de gözlemciler arası uyum istatistiksel olarak anlamlı ve transizyonel zonda çok zayıf (sırasıyla κ=0,383, κ=0,279), periferik zonda çok güçlü (κ=0,869) ve benzerdi.
Sonuç: PI-RADS v2 ve v2.1'in tanısal performansı, klinik olarak anlamlı kanserlerin ve her iki bölgedeki tüm kanserlerin tespitinde benzer bulundu. Geçiş bölgesindeki kategori 2+1 lezyonlarda klinik olarak anlamlı kanser tespit oranı, kategori 2 lezyonlara göre daha yüksekti ancak istatistiksel olarak anlamlı değildi. Her iki versiyonda da gözlemciler arası uyum transizyonel zonda düşük, periferik zonda ise çok güçlüydü.

Keywords

PI-RADS V2.1, klinik olarak anlamlı prostat kanseri, gözlemciler arası uyum

Comparison of Diagnostic Performance of PI-RADS V2 and V2.1 and Interobserver Agreement in Both Versions

Abstract

Objective: To compare the diagnostic performance for the detection of clinically significant prostate cancers and interobserver agreement between PI-RADS v2 and v2.1
Material and Method: The mpMRI images of 258 patients and 394 nodüles included in this retrospective study were obtained on 3T MR and evaluated by two radiologists according to PI-RADS v2 and v2.1. Sensitivity and specificity between v2 and v2.1 compared. Detection rates for clinically significant prostate cancers of upgraded and downgraded lesions in the use of v2.1 from v2 were assessed. Interobserver agreement was assessed using κ statistics.
Results: PI-RADS v2.1 and v2 showed higher sensitivity and lower specificity (100%, 52.38%) in peripheral zone and showed higher sensitivity and specificity (92.86%, 98.79%) in transition zone for category ≥4 lesions in the detection of csPCa, not significantly difference was found between the two versions. Interobserver agreement was statistically significant and very weak in the transition zone (κ=0.383, κ=0.279, respectively), very strong in the peripheral zone (κ=0.869) according to both classifications and they were similar.
Conclusion: The diagnostic performance of PI-RADS v2 and v2.1 were found similar in detecting clinically significant cancers and all cancers in both zones. The clinically significant cancer detection rate in category 2+1 lesions in the transition zone was higher than in category 2 lesions but it wasn’t statistically significant. Interobserver agreement was low in the transition zone and very strong in the peripheral zone in both versions.

Keywords

PI-RADS V2.1, clinically significant prostate cancer, interobserver agreement

Ethical Statement

Our institutional review board approved this retrospective study with a waiver of informed consent.

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