Are T2WI PI-RADS sub-scores of transition zone prostate lesions biased by DWI information? A multi-reader, single-center study.

Autor: Zhang KS; Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany., Mayer P; Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany., Glemser PA; Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany., Tavakoli AA; Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany., Keymling M; Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany., Rotkopf LT; Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany., Meinzer C; Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany., Görtz M; Department of Urology, University of Heidelberg Medical Center, Heidelberg, Germany; Junior Clinical Cooperation Unit 'Multiparametric Methods for Early Detection of Prostate Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany., Kauczor HU; Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany., Hielscher T; Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany., Stenzinger A; Institute of Pathology, University of Heidelberg Medical Center, Heidelberg, Germany., Bonekamp D; Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany; German Cancer Consortium (DKTK), Germany; National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany; Heidelberg University Medical School, Heidelberg, Germany. Electronic address: d.bonekamp@dkfz-heidelberg.de., Hohenfellner M; Department of Urology, University of Heidelberg Medical Center, Heidelberg, Germany., Schlemmer HP; Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany; German Cancer Consortium (DKTK), Germany; National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany.
Jazyk: angličtina
Zdroj: European journal of radiology [Eur J Radiol] 2023 Oct; Vol. 167, pp. 111026. Date of Electronic Publication: 2023 Aug 06.
DOI: 10.1016/j.ejrad.2023.111026
Abstrakt: Purpose: According to PI-RADS v2.1, T2-weighted imaging (T2WI) is the dominant sequence for transition zone (TZ) lesions. This study aimed to assess, whether diffusion-weighted imaging (DWI) information influences the assignment of T2WI scores.
Method: Out of 283 prostate MRI examinations with correlated biopsy results, fourty-four patients were selected retrospectively: first, 22 patients with a TZ lesion with T2WI and DWI scores ≥ 4, to represent lesions with unequivocal suspicion on T2WI and DWI. Second, 22 additional patients with TZ lesions of similar T2WI appearance but with corresponding DWI score ≤ 3 were added as control. Four residents and one board-certified radiologist each performed two assessments of the included patients: First, only T2WI was available (T2-only read); second, both T2WI and DWI sequences were available (biparametric read). Lesion scores were assessed using Wilcoxon signed-rank test, inter-reader agreement using weighted kappa and Kendall's W statistics, and sensitivity/specificity using McNemar test.
Results: The T2WI scores were significantly different between the T2-only and biparametric read for 3 out of 4 residents (p ≤ 0.049) but not for the radiologist. The overall PI-RADS scores derived from the two reading sessions differed considerably for 35/220 cases (all readers pooled). Inter-reader agreement was fair for the T2WI and overall PI-RADS scores (mean kappa 0.27-0.30) and moderate for the DWI scores (mean kappa 0.43).
Conclusions: For inexperienced readers, assessment of T2WI is variable and potentially biased by availability of DWI information, which can lead to changes of overall PI-RADS score and consequently clinical management. Assessment of T2WI should be performed before reviewing DWI to ensure non-biased interpretation of TZ lesions in the dominant sequence.
Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: KS Zhang, P. Mayer, PA Glemser, AA Tavakoli, M. Keymling, LT Rotkopf, M. Görtz, T. Hielscher and M. Hohenfellner have nothing to declare. C. Meinzer declares: Research funding: Bundesministerium für Wirtschaft und Klimaschutz (BMWK): 01MT21004B. HU Kauczor declares: Consulting fee or honoraria (speakers bureau): Siemens, Philips, Sanofi, Median; grants/research support: Siemens, Philips, Boehringer Ingelheim. A. Stenzinger declares: Research funding: Bayer, Bristol-Myers Squibb, Chugai, and Incyte; speaker’s honoraria: Aignostics, Amgen, Astra Zeneca, AGCT, Bayer, BMS, Eli Lilly, Illumina, Incyte, Janssen, MSD, Novartis, Pfizer, Qlucore, Roche, Seagen, Seattle Genetics, Takeda, and Thermo Fisher. D. Bonekamp declares: Payment for lectures: Bayer Vital. HP Schlemmer declares: Consulting fee or honorarium: Siemens, Curagita, Profound, Bayer; travel support: Siemens, Curagita, Profound, Bayer; board member: Curagita; consultancy: Curagita, Bayer; grants/grants pending: BMBF, Deutsche Krebshilfe, Dietmar-Hopp-Stiftung, Roland-Ernst-Stiftung; payment for lectures: Siemens, Curagita, Profound, Bayer.
(Copyright © 2023. Published by Elsevier B.V.)
Databáze: MEDLINE
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