title: Evaluation of the ESUR PI-RADS scoring system for multiparametric MRI of the prostate with targeted MR/TRUS fusion-guided biopsy at 3.0 Tesla.
abstract: OBJECTIVE
  To evaluate the Prostate Imaging Reporting and Data System (PI-RADS) proposed by the European Society of Urogenital Radiology (ESUR) for detection of prostate cancer (PCa) by multiparametric magnetic resonance imaging (mpMRI) in a consecutive cohort of patients with magnetic resonance/transrectal ultrasound (MR/TRUS) fusion-guided biopsy.
  
  
  METHODS
  Suspicious lesions on mpMRI at 3.0 T were scored according to the PI-RADS system before MR/TRUS fusion-guided biopsy and correlated to histopathology results. Statistical correlation was obtained by a Mann-Whitney U test. Receiver operating characteristics (ROC) and optimal thresholds were calculated.
  
  
  RESULTS
  In 64 patients, 128/445 positive biopsy cores were obtained out of 95 suspicious regions of interest (ROIs). PCa was present in 27/64 (42%) of the patients. ROC results for the aggregated PI-RADS scores exhibited higher areas under the curve compared to those of the Likert score. Sensitivity/Specificity for the following thresholds were calculated: 85 %/73 % and 67 %/92 % for PI-RADS scores of 9 and 10, respectively; 85 %/60 % and 56 %/97 % for Likert scores of 3 and 4, respectively [corrected.
  
  
  CONCLUSIONS
  The standardised ESUR PI-RADS system is beneficial to indicate the likelihood of PCa of suspicious lesions on mpMRI. It is also valuable to identify locations to be targeted with biopsy. The aggregated PI-RADS score achieved better results compared to the single five-point Likert score.
  
  
  CONCLUSIONS
  • The ESUR PI-RADS scoring system was evaluated using multiparametric 3.0-T MRI. • To investigate suspicious findings, transperineal MR/TRUS fusion-guided biopsy was used. • PI-RADS can guide biopsy locations and improve detection of clinically significant cancer. • Biopsy procedures can be optimised, reducing unnecessary negative biopsies for patients. • The PI-RADS scoring system may contribute to more effective prostate MRI.
authors.affiliation: Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, D-69120, Heidelberg, Germany, m.roethke@dkfz.de.
authors.forename: M C
authors.initials: MC
authors.lastname: Roethke
authors.forename: T H
authors.initials: TH
authors.lastname: Kuru
authors.forename: S
authors.initials: S
authors.lastname: Schultze
authors.forename: D
authors.initials: D
authors.lastname: Tichy
authors.forename: A
authors.initials: A
authors.lastname: Kopp-Schneider
authors.forename: M
authors.initials: M
authors.lastname: Fenchel
authors.forename: H-P
authors.initials: HP
authors.lastname: Schlemmer
authors.forename: B A
authors.initials: BA
authors.lastname: Hadaschik
mesh_terms: D000368:Aged; D005060:Europe; D005500:Follow-Up Studies; D006801:Humans; D061705:Image-Guided Biopsy; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000473:pathology*; D012372:ROC Curve; D015203:Reproducibility of Results; D012955:Societies, Medical; D014572:Urology