title: Inter-reader agreement of the ESUR score for prostate MRI using in-bore MRI-guided biopsies as the reference standard.
abstract: OBJECTIVE
  The recent European Society of Urogenital Radiology (ESUR) guidelines for evaluation and reporting of prostate multiparametric magnetic resonance imaging (mp-MRI) include the Prostate Imaging Reporting and Data System (PI-RADS). The aim of this study was to investigate the inter-reader agreement of this scoring system.
  
  
  METHODS
  One hundred and sixty-four lesions in 67 consecutive patients with elevated prostate-specific antigen and previously negative trans-rectal ultrasound (TRUS)-guided biopsy were scored retrospectively by three blinded readers using PI-RADS. Mp-MRI was performed at 3 T using T2-weighted, diffusion-weighted and dynamic contrast-enhanced imagings (T2WI, DWI, DCE-MRI). Histology of all lesions was obtained by in-bore MRI-guided biopsy. Cohen's kappa statistics were calculated for all readers.
  
  
  RESULTS
  Inter-reader agreement for all lesions was good to moderate (T2WI, κ = 0.55; DWI, κ = 0.64; DCE-MRI, κ = 0.65). For tumour lesions it was good (T2WI, κ = 0.66; DWI, κ = 0.80; DCE-MRI, κ = 0.63) and for benign lesions moderate to good (T2WI, κ = 0.46; DWI, κ = 0.52; DCE-MRI, κ = 0.67). Using an overall PI-RADS score with a threshold of ≥10, we achieved a sensitivity of 85.7 %, and negative predictive value of 90.1 % for biopsied lesions.
  
  
  CONCLUSIONS
  PI-RADS score shows good to moderate inter-reader agreement and enables standardised evaluation of prostate mp-MRI, with high sensitivity and negative predictive value.
  
  
  CONCLUSIONS
  • The European Society of Urogenital Radiology recently published guidelines for prostate MRI. • We have evaluated inter-reader agreement of ESUR scoring for multiparametric prostate MRI. • PI-RADS shows good to moderate inter-reader agreement and is clinically applicable. • PI-RADS achieves in our series high sensitivity and negative predictive value for biopsied lesions. • PI-RADS can be used as standardised scoring system in prostate cancer detection.
authors.affiliation: Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Schimmöller
authors.forename: M
authors.initials: M
authors.lastname: Quentin
authors.forename: C
authors.initials: C
authors.lastname: Arsov
authors.forename: R S
authors.initials: RS
authors.lastname: Lanzman
authors.forename: A
authors.initials: A
authors.lastname: Hiester
authors.forename: R
authors.initials: R
authors.lastname: Rabenalt
authors.forename: G
authors.initials: G
authors.lastname: Antoch
authors.forename: P
authors.initials: P
authors.lastname: Albers
authors.forename: D
authors.initials: D
authors.lastname: Blondin
mesh_terms: D000368:Aged; D005858:Germany; D006801:Humans; D061705:Image-Guided Biopsy / Q000592:standards*; D008279:Magnetic Resonance Imaging / Q000592:standards*; D008297:Male; D017410:Practice Guidelines as Topic; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D012372:ROC Curve; D012015:Reference Standards; D012189:Retrospective Studies; D012955:Societies, Medical; D014572:Urology