title: Diagnostic Performance of Prostate Imaging Reporting and Data System Version 2 for Detection of Prostate Cancer: A Systematic Review and Diagnostic Meta-analysis.
abstract: In 2015, the updated Prostate Imaging Reporting and Data System version 2 (PI-RADSv2) for the detection of prostate cancer (PCa) was established. Since then, several studies assessing the value of PI-RADSv2 have been published.
  
  
  
  To review the diagnostic performance of PI-RADSv2 for the detection of PCa.
  
  
  
  MEDLINE and EMBASE databases were searched up to December 7, 2016. We included diagnostic accuracy studies that used PI-RADSv2 for PCa detection, using prostatectomy or biopsy as the reference standard. The methodological quality was assessed by two independent reviewers using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Sensitivity and specificity of all studies were calculated. Results were pooled and plotted in a hierarchical summary receiver operating characteristic plot with further exploration using meta-regression and multiple subgroup analyses. Head-to-head comparison between PI-RADSv1 and PI-RADSv2 was performed for available studies.
  
  
  
  Twenty-one studies (3857 patients) were included. The pooled sensitivity was 0.89 (95% confidence interval [CI] 0.86-0.92) with specificity of 0.73 (95% CI 0.60-0.83) for PCa detection. Proportion of patients with PCa, magnetic field strength, and reference standard were significant factors affecting heterogeneity (p<0.01). Multiple subgroup analyses showed consistent results. In six studies performing head-to-head comparison, PI-RADSv2 demonstrated higher pooled sensitivity of 0.95 (95% CI 0.85-0.98) compared with 0.88 (95% CI 0.80-0.93) for PI-RADSv1 (p=0.04). However, the pooled specificity was not significantly different (0.73 [95% CI 0.47-0.89] vs 0.75 [95% CI 0.36-0.94], respectively; p=0.90).
  
  
  
  PI-RADSv2 shows good performance for the detection of PCa. PI-RADSv2 has higher pooled sensitivity than PI-RADSv1 without significantly different specificity.
  
  
  
  We reviewed all previous studies using Prostate Imaging Reporting and Data System version 2 (PI-RADSv2) for prostate cancer detection. We found that the updated PI-RADSv2 shows significant improvement compared with the original PI-RADSv1.
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Sungmin
authors.initials: S
authors.lastname: Woo
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea; Department of Radiology, Namwon Medical Center, Jeollabuk-do, Republic of Korea.
authors.forename: Chong Hyun
authors.initials: CH
authors.lastname: Suh
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul, Korea. Electronic address: iwishluv@empas.com.
authors.forename: Sang Youn
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul, Korea; Institute of Radiation Medicine and Kidney Research Institute, Seoul National University Medical Research Center, Seoul, Korea.
authors.forename: Jeong Yeon
authors.initials: JY
authors.lastname: Cho
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul, Korea; Institute of Radiation Medicine and Kidney Research Institute, Seoul National University Medical Research Center, Seoul, Korea.
authors.forename: Seung Hyup
authors.initials: SH
authors.lastname: Kim
mesh_terms: D000368:Aged; D019540:Area Under Curve; D001706:Biopsy; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D012372:ROC Curve; D015203:Reproducibility of Results; D012107:Research Design; D012984:Software
keywords: Magnetic resonance imaging; Meta-analysis; Prostate cancer; Prostate imaging reporting and data system version 2