A study on the diagnostic performance and consistency of clinically significant prostate cancer based on PI-RADS v2.1

ZHANG Jun; YIN Xuemei; GONG Zhigang; WANG Liang; YANG Zhenghan; ZHAO Chenglin

doi:10.19732/j.cnki.2096-6210.2023.03.006

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A study on the diagnostic performance and consistency of clinically significant prostate cancer based on PI-RADS v2.1

更新时间：2025-12-15

- A study on the diagnostic performance and consistency of clinically significant prostate cancer based on PI-RADS v2.1
- Vol. 32, Issue 3, Pages: 250-255(2023)
- 作者机构：
  
  1. 秦皇岛市第一医院医学影像科,河北,秦皇岛,066000
  2. 晋中市榆次区人民医院放射科,山西,晋中,030600
  3. 首都医科大学附属北京友谊医院放射科,北京,100032
- 作者简介：
- 基金信息：
- DOI：10.19732/j.cnki.2096-6210.2023.03.006
  CLC：
- Published Online：28 June 2023，
  
  Published：28 June 2023
- 稿件说明：
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张俊,尹雪梅,巩志刚,等. 基于PI-RADS v2.1对临床显著前列腺癌的诊断效能及一致性的研究[J]. 肿瘤影像学, 2023, 32(3): 250-255 https://doi.

org/10.19732/j.cnki.2096-6210.2023.03.006
张俊,尹雪梅,巩志刚,等. 基于PI-RADS v2.1对临床显著前列腺癌的诊断效能及一致性的研究[J]. 肿瘤影像学, 2023, 32(3): 250-255 https://doi. DOI： 10.19732/j.cnki.2096-6210.2023.03.006.

org/10.19732/j.cnki.2096-6210.2023.03.006 DOI：

摘要

目的：

比较不同年资放射科医师基于前列腺影像报告和数据系统2.1版（Prostate Imaging Reporting and Data System version 2.1，PI-RADS v2.1）评估临床显著前列腺癌（clinically significant prostate cancer，csPCa）的诊断效能并测试评分的一致性。

方法：

3名不同年资放射科医师（工作年限分别为8、6、3年）回顾并分析583例在前列腺活检前接受多参数磁共振成像（multiparametric magnetic resonance imaging，mpMRI）扫描的患者图像，将获得的诊断结果与病理学检查结果比较，绘制受试者工作特征（receiver operating characteristic，ROC）曲线，以确定三者的最佳诊断性能，使用Kappa检验评估3名放射科医师之间诊断评分的一致性。

结果：

3名不同年资放射科医师的诊断效能ROC曲线的曲线下面积（area under curve，AUC）分别为0.85、0.86、0.80；中、高年资医师的AUC比较差异无统计学意义（

=0.43）；高、中年资医师与低年资医师的AUC比较差异有统计学意义（

＜0.05）；高，中，低年资医师诊断的灵敏度、特异度、阳性预测值、阴性预测值分别为87%、82%、81%、88%，89%、82%、81%、90%和79%、82%、79%、82%。高年资和中年资医师诊断评分一致性中等（Kappa=0.70），中年资和低年资医师一致性较好（Kappa=0.76），高年资和低年资医师一致性中等（Kappa=0.64）。

结论：

不同年资医师使用PI-RADS v2.1对csPCa的诊断效能均较高，推荐临床应用。不同年资医师应用PI-RADS v2.1的诊断效能有差异，高、中年资医师优于低年资医师，但其诊断的一致性一般，PI-RADS v2.1仍需进一步改进。

Abstract

Objective:

To compare the diagnostic efficacy of radiologists of different seniority in assessing clinically significant prostate cance

r (csPCa) based on the Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1) and to test the consistency of the scores.

Methods:

Three radiologists with different seniority (working years are 8

3 years respectively) retrospectively analyzed images of 583 patients who underwent multiparametric magnetic resonance imaging (mpMRI) before prostate biopsy. Receiver operating characteristic (ROC) curve was drawn from the obtained diagnostic results and pathological results to determine the best diagnostic performance of the three. Using the Kappa test to assess the consistency of diagnostic scores among three radiologists.

Results:

The area under the ROC curve (AUC) of the diagnostic efficacy of three radiologists with different seniority were 0.85

0.86

0.80. There was no significant difference in AUC between senior and middle-aged physicians (

=0.43). There was a statistically significant difference in AUC between senior and middle-aged radiologists and junior senior radiologists (

＜0.05). The sensitivity

specificity

positive predictive value and negative predictive value of high

middle

andlow-qualified physicians were 87%

82%

81%

88%

and 89%

82%

81%

90%

and 79%

82%

79%

82%. The consistency results of the comparison of diagnostic scores between senior and middle-qualified physicians was moderate (Kappa=0.70)

between middle-qualified and junior physicians was good (Kappa=0.76)

and between senior and junior-qualified physicians was moderate (Kappa=0.64).

Conclusion:

The diagnostic efficacy of PI-RADS v2.1 for csPCa is high among physicians of different levels of experience and its recommended for clinical application. The diagnostic efficacy of PI-RADS v2.1 differed among different years of experience of physicians

with senior and middle-qualified physicians outperforming junior physicians

but the consistency of their diagnoses was average

and PI-RADS v2.1 still needs further improvement.

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