title: Prospective Evaluation of PI-RADS™ Version 2 Using the International Society of Urological Pathology Prostate Cancer Grade Group System.
abstract: The PI-RADS™ (Prostate Imaging Reporting and Data System), version 2 scoring system, introduced in 2015, is based on expert consensus. In the same time frame ISUP (International Society of Urological Pathology) introduced a new pathological scoring system for prostate cancer. Our goal was to prospectively evaluate the cancer detection rates for each PI-RADS, version 2 category and compare them to ISUP group scores in patients undergoing systematic biopsy and magnetic resonance imaging-transrectal ultrasound fusion guided biopsy.
  
  
  
  A total of 339 treatment naïve patients prospectively underwent multiparametric magnetic resonance imaging evaluated with PI-RADS, version 2 with subsequent systematic and fusion guided biopsy from May 2015 to May 2016. ISUP scores were applied to pathological specimens. An ISUP score of 2 or greater (ie Gleason 3 + 4 or greater) was defined as clinically significant prostate cancer. Cancer detection rates were determined for each PI-RADS, version 2 category as well as for the T2 weighted PI-RADS, version 2 categories in the peripheral zone.
  
  
  
  The cancer detection rate for PI-RADS, version 2 categories 1, 2, 3, 4 and 5 was 25%, 20.2%, 24.8%, 39.1% and 86.9% for all prostate cancer, and 0%, 9.6%, 12%, 22.1% and 72.4% for clinically significant prostate cancer, respectively. On T2-weighted magnetic resonance imaging the cancer detection rate in the peripheral zone was significantly higher for PI-RADS, version 2 category 4 than for overall PI-RADS, version 2 category 4 in the peripheral zone (all prostate cancer 36.6% vs 48.1%, p = 0.001, and clinically significant prostate cancer 22.9% vs 32.6%, p = 0.002).
  
  
  
  The cancer detection rate increases with higher PI-RADS, version 2 categories.
authors.affiliation: Department of Urology and Pediatric Urology, University Medical Center, Mainz, Germany; Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland; Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
authors.forename: Sherif
authors.initials: S
authors.lastname: Mehralivand
authors.affiliation: Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland; Center for Interventional Oncology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland; Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland; Institute of Diagnostic Radiology, Department of Medical and Biological Sciences, University of Udine, Udine, Italy.
authors.forename: Sandra
authors.initials: S
authors.lastname: Bednarova
authors.affiliation: Biometric Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Rockville, Maryland.
authors.forename: Joanna H
authors.initials: JH
authors.lastname: Shih
authors.affiliation: Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
authors.forename: Francesca V
authors.initials: FV
authors.lastname: Mertan
authors.affiliation: Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
authors.forename: Sonia
authors.initials: S
authors.lastname: Gaur
authors.affiliation: Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Merino
authors.affiliation: Center for Interventional Oncology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland; Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland.
authors.forename: Bradford J
authors.initials: BJ
authors.lastname: Wood
authors.affiliation: Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Pinto
authors.affiliation: Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
authors.forename: Peter L
authors.initials: PL
authors.lastname: Choyke
authors.affiliation: Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland. Electronic address: turkbeyi@mail.nih.gov.
authors.forename: Baris
authors.initials: B
authors.lastname: Turkbey
mesh_terms: D000368:Aged; D006801:Humans; D061705:Image-Guided Biopsy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D014463:Ultrasonography
keywords: biopsy; diagnostic imaging; early detection of cancer; prostatic neoplasms; reference standards