E. H. J. Hamoen MD, Presenter: Nothing to Disclose

Maarten De Rooij MD, Abstract Co-Author: Nothing to Disclose

Fred Witjes MD, PhD, Abstract Co-Author: Nothing to Disclose

Maroeska M. Rovers PhD, Abstract Co-Author: Nothing to Disclose

Jelle O. Barentsz MD, PhD, Abstract Co-Author: Nothing to Disclose

To determine the diagnostic accuracy of the Prostate Imaging Reporting and Data System (PI-RADS) in prostate cancer detection using multiparametric magnetic resonance imaging (mp-MRI).

We searched electronic databases, including MEDLINE, Embase, and Cochrane Central Register of Controlled Trials, up to March 20, 2014. We included diagnostic accuracy studies referring to the use of PI-RADS scales to detect prostate cancer on mp-MRI. Histopathologic data from prostatectomy or biopsy could be used as the reference standard. Data necessary to complete 2x2 contingency tables were obtained from the included studies, and test characteristics including sensitivity, specificity, and predictive values were calculated. Sensitivity and specificity values of all included studies were pooled and the results were plotted in a summary receiver operating characteristics plot.

Fourteen studies that met the inclusion criteria (1785 patients) could be analyzed. The pooled data showed a specificity of 0.79 (95% CI, 0.69–0.86) and sensitivity of 0.78 (95% CI, 0.70–0.84) for prostate cancer detection, with negative predictive values (NPVs) ranging from 0.58 to 0.95. Subgroup analysis showed a pooled specificity of 0.84 (95% CI, 0.71–0.92) and sensitivity of 0.81 (95% CI, 0.71–0.88) in studies that correctly used the PI-RADS criteria per modality, versus a specificity of 0.71 (95% CI, 0.58–0.80) and sensitivity of 0.73 (95% CI, 0.60–0.83) in studies with a probably less strict or adjusted use of PI-RADS criteria.

Accurate use of PI-RADS leads to good sensitivity and specificity rates for prostate cancer detection. Included studies showed fairly large heterogeneity regarding the calculation of an overall PI-RADS score and used cut-off values. Therefore, a standardized method for deriving an overall score is needed for a correct comparison of different studies.

PI-RADS is a promising tool for prostate cancer detection and is recommended in the evaluation of mp-MRI in men suspicious for prostate cancer.

Hamoen, E, De Rooij, M, Witjes, F, Rovers, M, Barentsz, J, The Use of the Prostate Imaging Reporting and Data System (PI-RADS) for Prostate Cancer Diagnosis on Multiparametric Magnetic Resonance Imaging: A Systematic Review and Meta-analysis.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14007179.html