@article{a5758d6b91dc4a628f058a994b8533e5,
title = "Variability of the Positive Predictive Value of PI-RADS for Prostate MRI across 26 Centers: Experience of the Society of Abdominal Radiology Prostate Cancer Disease-focused Panel: Experience of the society of abdominal radiology prostate cancer disease-focused panel",
abstract = "Background Prostate MRI is used widely in clinical care for guiding tissue sampling, active surveillance, and staging. The Prostate Imaging Reporting and Data System (PI-RADS) helps provide a standardized probabilistic approach for identifying clinically significant prostate cancer. Despite widespread use, the variability in performance of prostate MRI across practices remains unknown. Purpose To estimate the positive predictive value (PPV) of PI-RADS for the detection of high-grade prostate cancer across imaging centers. Materials and Methods This retrospective cross-sectional study was compliant with the HIPAA. Twenty-six centers with members in the Society of Abdominal Radiology Prostate Cancer Disease-focused Panel submitted data from men with suspected or biopsy-proven untreated prostate cancer. MRI scans were obtained between January 2015 and April 2018. This was followed with targeted biopsy. Only men with at least one MRI lesion assigned a PI-RADS score of 2-5 were included. Outcome was prostate cancer with Gleason score (GS) greater than or equal to 3+4 (International Society of Urological Pathology grade group >/=2). A mixed-model logistic regression with institution and individuals as random effects was used to estimate overall PPVs. The variability of observed PPV of PI-RADS across imaging centers was described by using the median and interquartile range. Results The authors evaluated 3449 men (mean age, 65 years +/- 8 [standard deviation]) with 5082 lesions. Biopsy results showed 1698 cancers with GS greater than or equal to 3+4 (International Society of Urological Pathology grade group >/=2) in 2082 men. Across all centers, the estimated PPV was 35% (95% confidence interval [CI]: 27%, 43%) for a PI-RADS score greater than or equal to 3 and 49% (95% CI: 40%, 58%) for a PI-RADS score greater than or equal to 4. The interquartile ranges of PPV at these same PI-RADS score thresholds were 27%-44% and 27%-48%, respectively. Conclusion The positive predictive value of the Prostate Imaging and Reporting Data System was low and varied widely across centers. (c) RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Milot in this issue.",
keywords = "Aged, Cross-Sectional Studies, Humans, Magnetic Resonance Imaging/methods, Male, Predictive Value of Tests, Prostate/diagnostic imaging, Prostatic Neoplasms/diagnostic imaging, Radiology Information Systems, Reproducibility of Results, Retrospective Studies, Societies, Medical",
author = "Westphalen, {A. C.} and McCulloch, {C. E.} and Anaokar, {J. M.} and S. Arora and Barashi, {N. S.} and Barentsz, {J. O.} and Bathala, {T. K.} and Bittencourt, {L. K.} and Booker, {M. T.} and Braxton, {V. G.} and Carroll, {P. R.} and Casalino, {D. D.} and Chang, {S. D.} and Coakley, {F. V.} and R. Dhatt and Eberhardt, {S. C.} and Foster, {B. R.} and Froemming, {A. T.} and Futterer, {J. J.} and Ganeshan, {D. M.} and Gertner, {M. R.} and {Mankowski Gettle}, L. and S. Ghai and Gupta, {R. T.} and Hahn, {M. E.} and R. Houshyar and C. Kim and Kim, {C. K.} and C. Lall and Margolis, {D. J. A.} and McRae, {S. E.} and A. Oto and Parsons, {R. B.} and Patel, {N. U.} and Pinto, {P. A.} and Polascik, {T. J.} and B. Spilseth and Starcevich, {J. B.} and Tammisetti, {V. S.} and Taneja, {S. S.} and B. Turkbey and S. Verma and Ward, {J. F.} and Warlick, {C. A.} and Weinberger, {A. R.} and J. Yu and Zagoria, {R. J.} and Rosenkrantz, {A. B.}",
note = "1527-1315 Westphalen, Antonio C ORCID: https://orcid.org/0000-0001-5762-9342 McCulloch, Charles E ORCID: https://orcid.org/0000-0002-1279-6179 Anaokar, Jordan M Arora, Sandeep Barashi, Nimrod S ORCID: https://orcid.org/0000-0002-2193-9928 Barentsz, Jelle O Bathala, Tharakeswara K Bittencourt, Leonardo K Booker, Michael T ORCID: https://orcid.org/0000-0002-1114-7150 Braxton, Vaughn G Carroll, Peter R Casalino, David D ORCID: https://orcid.org/0000-0002-0131-2183 Chang, Silvia D ORCID: https://orcid.org/0000-0002-9201-8114 Coakley, Fergus V ORCID: https://orcid.org/0000-0001-7455-8427 Dhatt, Ravjot Eberhardt, Steven C ORCID: https://orcid.org/0000-0003-4359-2555 Foster, Bryan R Froemming, Adam T Futterer, Jurgen J ORCID: https://orcid.org/0000-0001-6800-2879 Ganeshan, Dhakshina M ORCID: https://orcid.org/0000-0001-5027-3347 Gertner, Mark R Mankowski Gettle, Lori ORCID: https://orcid.org/0000-0002-2810-2792 Ghai, Sangeet Gupta, Rajan T Hahn, Michael E Houshyar, Roozbeh ORCID: https://orcid.org/0000-0003-4263-5533 Kim, Candice Kim, Chan Kyo Lall, Chandana Margolis, Daniel J A ORCID: https://orcid.org/0000-0001-8212-707X McRae, Stephen E ORCID: https://orcid.org/0000-0001-8524-5530 Oto, Aytekin ORCID: https://orcid.org/0000-0003-4325-2489 Parsons, Rosaleen B Patel, Nayana U ORCID: https://orcid.org/0000-0002-1131-3964 Pinto, Peter A Polascik, Thomas J Spilseth, Benjamin Starcevich, Juliana B ORCID: https://orcid.org/0000-0001-8633-6530 Tammisetti, Varaha S ORCID: https://orcid.org/0000-0002-2682-621X Taneja, Samir S Turkbey, Baris ORCID: https://orcid.org/0000-0003-0853-6494 Verma, Sadhna Ward, John F Warlick, Christopher A ORCID: https://orcid.org/0000-0002-8697-9015 Weinberger, Andrew R Yu, Jinxing ORCID: https://orcid.org/0000-0001-8448-5436 Zagoria, Ronald J ORCID: https://orcid.org/0000-0001-6926-4627 Rosenkrantz, Andrew B ORCID: https://orcid.org/0000-0002-1558-5350 Journal Article United States Radiology. 2020 Apr 21:190646. doi: 10.1148/radiol.2020190646.",
year = "2020",
doi = "10.1148/radiol.2020190646",
language = "English",
volume = "296",
pages = "76--84",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "1",
}
