Diagnostic Performance Of PI-RADS V2 Predicts Biopsy Outcome In Prostate Biopsy Naive Patients

Prostate cancer has been a commonly malignant tumor in men.As prostate-specific antigen(PSA)has been promoted a preferred tumor marker for the primary screening of prostate cancer,more and more underlying Prostate cancer patients who finally identified by prostate biopsy had been exposed.At the same time,many Benign prostatic hyperplasia patients accepted prostate biopsy,over-diagnosis appeared.MRI,as a noninvasive imageology procedure,has been widely focused on for it prominent efficient in diagnosis.Multiparametric MRI(mpMRI)was widespread used for detecting Prostate cancer,guiding prostate biopsy and so on.As mp-MRI became more widely validated,the European Society of Urogenital Radiology(ESUR)released the Prostate Imaging Reporting and Data System version 1(PI-RADS v1)to provide standardized guidelines for image acquisition and interpretation.In order to improve the shortcoming of PI-RADS v1,an updated version of PI-RADS was proposed in 2014 by the AdMeTech Foundation,the American College of Radiology(ACR)and ESUR.Purpose:As a new diagnosis standard of mp-MRI for prostate cancer,PI-RADS v2 has not been identifies by Chinese people.Firstly,We searched the relevant literature to grasp progression of PI-RADS,then PI-RADS v2 were executed on patients in our department to verified its efficient in diagnosis.Motheds:1.How Prostate Imaging Reporting and Data System Version generated and advances?We searched Pubmed and other online libraries to acquire articles that PI-RADS related and overviewed How Prostate Imaging Reporting and Data System Version generated and advances.2.Diagnostic performance of PI-RADS v2 predicts biopsy outcome in prostate biopsy naive patients.A total of 147 patients in hospital from 2015.10 to 2017.06 with information of PI-RADS v2 and prostate biopsy were included.Receiver Operating Characteristic(ROC)analysis was done to evaluate the discriminative value of distinguishing between lesions with and without a malignant tumor.The area under the ROC curve(AUC),Sensitivity,Specificity,Accuracy,Youden index,Positive predictive value,Negative predictive value were used.At last,tPSA and PSAD were compared to PI-RADS v2.Result:l.How Prostate Imaging Reporting and Data System Version generated and advances?The Prostate Imaging Reporting and Data System(PI-RADS)v1 was introduced by ESUR.Two years later,in December 2014,an updated version of the PI-RADS scoring system has been issued by ESUR,AdMeTech foundation and the PI-RADS steering committee of the American College of Radiology.MRSI was excluded from PI-RADS v2.PI-RADS v1 has lower pooled sensitivity(PI-RADS v1:88%vs PI-RADS v2:95%,p=0.04)than PI-RADS v2 without significantly different specificity(PI-RADS v1:75%vs PI-RADS v2:73%,p=0.90).Performance was better with the Likert scale than the PI-RADS scale(AUC:0.842 vs 0.747).PI-RADS v2 may be helpful to predict biochemical recurrence after radical prostatectomy for prostate cancer.On the other hand,PI-RADSv2 can help experienced readers to predict Gleason score>6 prostate cancers in patients with a biopsy Gleason score of 6(accuracy:87.4%).The PI-RADSv2 scoring system was also an independent predictor of pathological downgrading after RP in patients with biopsy-proven GS 7(3+4)PCa.2.Diagnostic performance of PI-RADS v2 predicts biopsy outcome in prostate biopsy naive patientsThere were 147 patients included.61 prostate cancer patients and 86 BPH patients.Positive rate of prostate cancer is 41.5%.The probability of cancer detection for PI-RADS v2 category 2,3,4,and 5 lesions was showed a upgrade tend.The AUC of PI-RADS v2 is 0.821 for all patients and 0.718 for patients with gray-zone PSA levels.The Sensitivity,Specificity,Accuracy,Youden index,Positive predictive value,Negative predictive value are 85.2%?65.1%?73.5%?0.503?63.4%?86.2%,while 78.6%?64.8%?82.4%?0.434?36.7%?92.1%for patients with gray-zone PSA levels.Compared to tPSA and PSAD,PI-RADS v2 has ahigher AUC(0.762?0.806?0.821)and Youden index(0.398?0.496?0.503).A similar result existed for patients with gray-zone PSA levels.At last,PI-RADS v2 is also a independent predictor of PCa diagnosis.Conclusion:1.How Prostate Imaging Reporting and Data System Version generated and advances?PI-RADS v2 is a reliable and replicable reporting system for the assessment of prostate cancer.PI-RADS v2 play a better performance than PI-RADS v1.But PI-RADS v2 may not better than Likert.PI-RADS v2 was also useful in identifying clinically significant prostate cancers in patients with a biopsy Gleason score of 6,predicting pathological downgrading and biochemical recurrence after radical prostatectomy.2.Diagnostic performance of PI-RADS v2 predicts biopsy outcome in prostate biopsy naive patients.PI-RADS v2 showed a high efficient in diagnosis for Chinese people.It is a good Imaging procedure for clinicians.