The Value Of PI-RADS V2 In Imaging Diagnosis Of Prostate Cancer

Objective:Based on PI-RADS Version 2(PI-RADS V2)scoring system,retrospective evaluation of prostate multi-parameter MRI for prostate cancer diagnosis consistency,repeatability,time-consuming and qualitative diagnostic efficacy,in order to comprehensively evaluate its clinical application valueMethods:Retrospectively analyzed the cases of multi-parametric MRI examination of prostate from January 2015 to September 2017,and selected 224 consecutive cases of prostate multi-parameter MRI for the purpose of qualitative diagnosis according to the standard of the row.The study was approved by the ethics committee of the hospital.Histopathology was obtained within 3 months after MRI examination,and long-term follow-up was performed to determine the nature of prostate lesions.Two different prostate MRI diagnostic physicians(R1,R2)were trained in two rounds of PI-RADS V2,and based on the PI-RADS V2 scoring system,the two-wheel independent blind reading of the axial position T2WI,DWI,and DCE was performed.Record lesion location,sequence score,overall score,reading time,and remark information(including correction score).The reading time of the two readers was analyzed by independent sample t test or non-parametric rank sum test.The scores were analyzed by Kappa test consistency and repeatability analysis,ROC curve diagnostic efficacy analysis,and misdiagnosis and missed cases were analyzed.P<0.05 was considered statistically significantResults:108 patients with prostate cancer and 116 patients with benign prostate lesions were enrolled.The reading time of the second round of R1 and R2 was shorter than that of the first round.The first round and the second round of R1 were longer than R2,and the difference was statistically significant(Z=-5.356～-2.438,P=0.000～0.015).There was no significant difference in the reading time between the two readers for the transition zone and peripheral lesions(Z=-1.090～-0.486,P=0.276～0.626);two readers for benign lesions The reading time was higher than that of malignant lesions,and the difference was statistically significant(Z=-6.723～-3.539,P=0.000).The reproducibility of the two rounds before and after R1 and R2 is good(kappa value=0.752/0.665,P=0.000);the consistency of the two readers in the first round and the second round is medium(kappa value=0.589,P)=0.000),good(kappa value=0.702,P=0.000);the scores of the two tape readers for the transition zone and the peripheral zone are good(Kappa value=0.699/0.631,P=0.000);scores for malignant and benign lesions The two readers had moderate agreement(Kappa value=0.4403/0.561,P=0.000).In the first round of overall and transitional lesions,the second round of overall diagnostic efficacy R1 was higher than R2(Z=2.488-3.197,P=0.0014-0.0128),the first round of peripheral lesions,the second round of peripheral zone and the diagnostic ability of the transition zone There was no statistical difference(Z=1.022～1.524;P=0.1275～0.3066);the second round of R2 overall and transitional lesions was higher than the first round(Z=2.068～2.267;P=0.0234～0.0387);R1 two There was no significant difference in the diagnostic efficacy between the whole and the zonal lesions and the peripheral lesions between the two rounds(Z=0.761～1.71 1;P=0.0871～0.4466).The area under the ROC curve(AUC)of the PI-RADS V2 collegiate scores of the two readers for the prostate,the peripheral zone,and the transition zone were 0.947,0.916,and 0.933,respectively.The sensitivity/specificity for the diagnosis of prostate cancer was 78.7.%/98.28%,80.26%/94.87%,87.5%/94.81%.The PI-RADS V2 score was positively correlated with the pathology of the puncture,r=0.459.PI-RADS V2 score was misdiagnosed in 18 cases,the misdiagnosis rate was 15.5%(18/116);9 cases were missed,and the missed diagnosis rate was 8.3%(9/108).The correction score was reduced by 8 cases of misdiagnosis,and the rate of misdiagnosis decreased by 6.9%.Conclusion:PI-RADS V2 has good clinical applicability.Through standardized training,it can achieve high consistency,repeatability and prostate cancer diagnosis efficiency.Its diagnostic efficiency and readers’ PI-RADS scoring system mastery degree,read The time consumption of the film is related.For some lesions(prostatitis,etc.),there are certain limitations in using the PI-RADS V2 scoring system for interpretation.It is necessary to combine the other imaging features to help the differential diagnosis.