Are T2WI PI-RADS sub-scores of transition zone prostate lesions biased by DWI information?

• Verfasst von: Zhang, Kevin Sun [VerfasserIn]
• Verfasst von: Mayer, Philipp [VerfasserIn]
• Verfasst von: Glemser, Philip [VerfasserIn]
• Verfasst von: Tavakoli, Andrej [VerfasserIn]
• Verfasst von: Keymling, Myriam [VerfasserIn]
• Verfasst von: Rotkopf, Lukas Thomas [VerfasserIn]
• Verfasst von: Meinzer, Clara [VerfasserIn]
• Verfasst von: Görtz, Magdalena [VerfasserIn]
• Verfasst von: Kauczor, Hans-Ulrich [VerfasserIn]
• Verfasst von: Hielscher, Thomas [VerfasserIn]
• Verfasst von: Stenzinger, Albrecht [VerfasserIn]
• Verfasst von: Bonekamp, David [VerfasserIn]
• Verfasst von: Hohenfellner, Markus [VerfasserIn]
• Verfasst von: Schlemmer, Heinz-Peter [VerfasserIn]
• Titel: Are T2WI PI-RADS sub-scores of transition zone prostate lesions biased by DWI information?
• Titelzusatz: A multi-reader, single-center study
• Verf.angabe: Kevin Sun Zhang, Philipp Mayer, Philip Alexander Glemser, Anoshirwan Andrej Tavakoli, Myriam Keymling, Lukas Thomas Rotkopf, Clara Meinzer, Magdalena Görtz, Hans-Ulrich Kauczor, Thomas Hielscher, Albrecht Stenzinger, David Bonekamp, Markus Hohenfellner, Heinz-Peter Schlemmer
• E-Jahr: 2023
• Jahr: October 2023
• Umfang: 8 S.
• Fussnoten: Gesehen am 08.11.2023
• Titel Quelle: Enthalten in: European journal of radiology
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1990
• Jahr Quelle: 2023
• Band/Heft Quelle: 167(2023) vom: Okt., Artikel-ID 111026, Seite 1-8
• ISSN Quelle: 1872-7727
• DOI: doi:10.1016/j.ejrad.2023.111026
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Magnetic resonance imaging
• Sach-SW: PI-RADS
• Sach-SW: PIRADS
• Sach-SW: Prostate cancer
• Sach-SW: Transition zone
• Sach-SW: TZ
• K10plus-PPN: 1869724135

Abstract

Purpose - According to PI-RADS v2.1, T2-weighted imaging (T2WI) is the dominant sequence for transition zone (TZ) lesions. This study aimed to assess, whether diffusion-weighted imaging (DWI) information influences the assignment of T2WI scores. - Method - Out of 283 prostate MRI examinations with correlated biopsy results, fourty-four patients were selected retrospectively: first, 22 patients with a TZ lesion with T2WI and DWI scores ≥ 4, to represent lesions with unequivocal suspicion on T2WI and DWI. Second, 22 additional patients with TZ lesions of similar T2WI appearance but with corresponding DWI score ≤ 3 were added as control. Four residents and one board-certified radiologist each performed two assessments of the included patients: First, only T2WI was available (T2-only read); second, both T2WI and DWI sequences were available (biparametric read). Lesion scores were assessed using Wilcoxon signed-rank test, inter-reader agreement using weighted kappa and Kendall's W statistics, and sensitivity/specificity using McNemar test. - Results - The T2WI scores were significantly different between the T2-only and biparametric read for 3 out of 4 residents (p ≤ 0.049) but not for the radiologist. The overall PI-RADS scores derived from the two reading sessions differed considerably for 35/220 cases (all readers pooled). Inter-reader agreement was fair for the T2WI and overall PI-RADS scores (mean kappa 0.27-0.30) and moderate for the DWI scores (mean kappa 0.43). - Conclusions - For inexperienced readers, assessment of T2WI is variable and potentially biased by availability of DWI information, which can lead to changes of overall PI-RADS score and consequently clinical management. Assessment of T2WI should be performed before reviewing DWI to ensure non-biased interpretation of TZ lesions in the dominant sequence.