Original Research

Interobserver agreement of PI-RADS v. 2 lexicon among radiologists with different levels of experience

Corresponding Author

Thais C. Mussi MD, PhD

[email protected]

orcid.org/0000-0001-8231-2646

Radiology and Diagnostic Imaging Department, Hospital Israelita Albert Einstein, São Paulo, Brazil

Address reprint requests to: T.C.M., Av. Albert Einstein, 627 - Jardim Leonor, São Paulo - SP, 05652-900, Brazil. E-mail: [email protected].Search for more papers by this author

Fernando I. Yamauchi MD,

Fernando I. Yamauchi MD

Radiology and Diagnostic Imaging Department, Hospital Israelita Albert Einstein, São Paulo, Brazil

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Cássia F. Tridente MD,

Cássia F. Tridente MD

Radiology and Diagnostic Imaging Department, Hospital Israelita Albert Einstein, São Paulo, Brazil

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Adriano Tachibana MD, PhD,

Adriano Tachibana MD, PhD

Radiology and Diagnostic Imaging Department, Hospital Israelita Albert Einstein, São Paulo, Brazil

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Victor M. Tonso MD, MSc,

Victor M. Tonso MD, MSc

Radiology and Diagnostic Imaging Department, Hospital Israelita Albert Einstein, São Paulo, Brazil

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Débora Z. Recchimuzzi MD,

Débora Z. Recchimuzzi MD

Radiology and Diagnostic Imaging Department, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil

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Layra R.S. Leão MD,

Layra R.S. Leão MD

Radiology and Diagnostic Imaging Department, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil

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Daniel C. Luz MD,

Daniel C. Luz MD

Radiology and Diagnostic Imaging Department, Hospital Israelita Albert Einstein, São Paulo, Brazil

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Tatiana Martins MD,

Tatiana Martins MD

Radiology and Diagnostic Imaging Department, Hospital Israelita Albert Einstein, São Paulo, Brazil

Ecoar Medicina Diagnóstica, Belo Horizonte, Brazil

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Ronaldo H. Baroni MD, PhD,

Ronaldo H. Baroni MD, PhD

Radiology and Diagnostic Imaging Department, Hospital Israelita Albert Einstein, São Paulo, Brazil

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Thais C. Mussi MD, PhD,

Corresponding Author

Thais C. Mussi MD, PhD

[email protected]

orcid.org/0000-0001-8231-2646

Radiology and Diagnostic Imaging Department, Hospital Israelita Albert Einstein, São Paulo, Brazil

Address reprint requests to: T.C.M., Av. Albert Einstein, 627 - Jardim Leonor, São Paulo - SP, 05652-900, Brazil. E-mail: [email protected].Search for more papers by this author

Fernando I. Yamauchi MD,

Fernando I. Yamauchi MD

Radiology and Diagnostic Imaging Department, Hospital Israelita Albert Einstein, São Paulo, Brazil

Search for more papers by this author

Cássia F. Tridente MD,

Cássia F. Tridente MD

Radiology and Diagnostic Imaging Department, Hospital Israelita Albert Einstein, São Paulo, Brazil

Search for more papers by this author

Adriano Tachibana MD, PhD,

Adriano Tachibana MD, PhD

Radiology and Diagnostic Imaging Department, Hospital Israelita Albert Einstein, São Paulo, Brazil

Search for more papers by this author

Victor M. Tonso MD, MSc,

Victor M. Tonso MD, MSc

Radiology and Diagnostic Imaging Department, Hospital Israelita Albert Einstein, São Paulo, Brazil

Search for more papers by this author

Débora Z. Recchimuzzi MD,

Débora Z. Recchimuzzi MD

Radiology and Diagnostic Imaging Department, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil

Search for more papers by this author

Layra R.S. Leão MD,

Layra R.S. Leão MD

Radiology and Diagnostic Imaging Department, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil

Search for more papers by this author

Daniel C. Luz MD,

Daniel C. Luz MD

Radiology and Diagnostic Imaging Department, Hospital Israelita Albert Einstein, São Paulo, Brazil

Search for more papers by this author

Tatiana Martins MD,

Tatiana Martins MD

Radiology and Diagnostic Imaging Department, Hospital Israelita Albert Einstein, São Paulo, Brazil

Ecoar Medicina Diagnóstica, Belo Horizonte, Brazil

Search for more papers by this author

Ronaldo H. Baroni MD, PhD,

Ronaldo H. Baroni MD, PhD

Radiology and Diagnostic Imaging Department, Hospital Israelita Albert Einstein, São Paulo, Brazil

Search for more papers by this author

First published: 01 August 2019

https://doi.org/10.1002/jmri.26882

Citations: 23

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Abstract

Background

Evaluation of interobserver agreement of the PI-RADS v2 lexicon is important to validate the uniformity of this widely used classification.

Purpose

To determine the interobserver agreement of PI-RADS v2 lexicon among eight radiologists with varying levels of experience.

Study Type

Retrospective.

Population

In all, 160 consecutively imaged men with confirmatory targeted biopsy.

Field Strength/Sequence

3T scanner without an endorectal coil. T₂-weighted imaging (T₂w), diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) map and dynamic contrast-enhanced sequence were performed.

Assessment

Eight radiologists (two highly experienced, two moderately experienced, and four less experienced) independently read 130 lesions in the peripheral zone (PZ) and 30 lesions in the transition zone (TZ), blinded to clinical MRI indication and biopsy results. The features described in PI-RADS v2 for TZ and PZ lesions were evaluated.

Statistical Tests

Conger's kappa, percentage of concordance, and first-order agreement coefficient (AC1) were used to evaluate interobserver agreement.

Results

From the features evaluated on PZ lesions, definite extraprostatic extension (EPE) / invasive behavior on T₂w had good agreement (AC1 = 0.80), and the others had fair agreement (AC1 = 0.32–0.40). From the features evaluated on TZ lesions, two had good agreement: definite EPE/invasive behavior (AC1 = 0.77) and moderate/marked hypointensity (AC1 = 0.67) on T₂w. Encapsulation and lenticular shape on T₂w, focal (not indistinct) on DWI and ADC map, and marked hypointensity on ADC map (AC1 = 0.45 to 0.60) had moderate agreement, whereas heterogeneous and circumscribed (not obscured margins) on T₂w, marked hyperintensity on high-b-value DWI, and the presence or not of early enhancement in the lesion/region of the lesion (AC1 = 0.30 to 0.38) had fair agreement.

Data Conclusion

Interobserver agreement in PI-RADS v2 lexicon ranges from fair to good among radiologists and improves with increasing experience.

Level of Evidence: 2

Technical Efficacy: Stage 2

J. Magn. Reson. Imaging 2020;51:593–602.

Conflict of Interest

The authors declare that they have no conflicts of interest.

References

1Barentsz JO, Richenberg J, Clements R, et al. ESUR prostate MR guidelines 2012. Eur Radiol 2012; 22: 746–757.
10.1007/s00330-011-2377-y
PubMed Web of Science® Google Scholar
2Weinreb JC, Barentsz JO, Choyke PL, et al. PI-RADS Prostate Imaging-Reporting and Data System: 2015, Version 2. Eur Urol 2016; 69: 16–40.
10.1016/j.eururo.2015.08.052
PubMed Web of Science® Google Scholar
3Vargas HA, Hötker AM, Goldman DA, et al. Updated prostate imaging reporting and data system (PIRADS v2) recommendations for the detection of clinically significant prostate cancer using multiparametric MRI: Critical evaluation using whole-mount pathology as standard of reference. Eur Radiol 2016; 26: 1606–1612.
10.1007/s00330-015-4015-6
CAS PubMed Web of Science® Google Scholar
4Greer MD, Shih JH, Lay N, et al. Validation of the dominant sequence paradigm and role of dynamic contrast-enhanced imaging in PI-RADS Version 2. Radiology 2017; 285: 859–869.
10.1148/radiol.2017161316
PubMed Web of Science® Google Scholar
5Rosenkrantz AB, Ginocchio LA, Cornfeld D, et al. Interobserver reproducibility of the PI-RADS Version 2 Lexicon: A multicenter study of six experienced prostate radiologists. Radiology 2016; 280: 793–804.
10.1148/radiol.2016152542
PubMed Web of Science® Google Scholar
6Zhao C, Gao G, Fang D, et al. The efficiency of multiparametric magnetic resonance imaging (mpMRI) using PI-RADS Version 2 in the diagnosis of clinically significant prostate cancer. Clin Imaging 2016; 40: 885–888.
10.1016/j.clinimag.2016.04.010
PubMed Web of Science® Google Scholar
7Muller BG, Shih JH, Sankineni S, et al. Prostate cancer: Interobserver agreement and accuracy with the revised Prostate Imaging Reporting and Data System at multiparametric MR imaging. Radiology 2015; 277: 741–750.
10.1148/radiol.2015142818
PubMed Web of Science® Google Scholar
8Mussi TC, Yamauchi FI, Tridente CF, et al. Interobserver agreement and positivity of PI-RADS Version 2 among radiologists with different levels of experience. Acad Radiol 2018 [Epub ahead of print] doi:https://doi.org/10.1016/j.acra.2018.08.013.
10.1016/j.acra.2018.08.013
PubMed Web of Science® Google Scholar
9Greer MD, Brown AM, Shih JH, et al. Accuracy and agreement of PIRADSv2 for prostate cancer mpMRI: A multireader study. J Magn Reson Imaging 2016; 45: 579–585.
10.1002/jmri.25372
PubMed Web of Science® Google Scholar
10Purysko AS, Bittencourt LK, Bullen JA, Mostardeiro TR, Herts BR, Klein EA. Accuracy and interobserver agreement for Prostate Imaging Reporting and Data System, Version 2, for the characterization of lesions identified on multiparametric MRI of the prostate. AJR Am J Radiol 2017; 209: 339–349.
Google Scholar
11Epstein JI, Walsh PC, Carmichael M, Brendler CB. Pathologic and clinical findings to predict tumor extent of nonpapable (stage T1c) prostate cancer. JAMA 1994; 271: 368–374.
10.1001/jama.1994.03510290050036
CAS PubMed Web of Science® Google Scholar
12Grimm LJ, Anderson AL, Baker JA, et al. Interobserver variability between breast imagers using the fifth edition of the BI-RADS MRI lexicon. AJR Am J Radiol 2015; 204: 1120–1124.
Google Scholar
13Ehman EC, Behr SC, Umetsu SE, et al. Rate of observation and inter-observer agreement for LI-RADS major features at CT and MRI in 184 pathology proven hepatocellular carcinomas. Abdom Radiol 2016; 41: 963–969.
10.1007/s00261-015-0623-5
PubMed Web of Science® Google Scholar
14Grani G, Lamartina L, Cantisani V, Maranghi M, Lucia P, Durante C. Interobserver agreement of various thyroid imaging reporting and data systems. Endocr Connect 2017; 7: 1–7.
10.1530/EC-17-0336
PubMed Web of Science® Google Scholar
15Turkbey B, Choyke PL. Future perspectives and challenges of prostate MR imaging. Radiol Clin North Am 2018; 56: 327–337.
10.1016/j.rcl.2017.10.013
PubMed Web of Science® Google Scholar

Citing Literature

Volume51, Issue2

February 2020

Pages 593-602

Interobserver agreement of PI-RADS v. 2 lexicon among radiologists with different levels of experience

Abstract

Background

Purpose

Study Type

Population

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

Conflict of Interest

References

Citing Literature

References

Information

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Interobserver agreement of PI-RADS v. 2 lexicon among radiologists with different levels of experience

Abstract

Background

Purpose

Study Type

Population

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

Conflict of Interest

References

Citing Literature

References

Related

Information