PI-RADS version 2: evaluation of diffusion-weighted imaging interpretation between <i>b</i>=1000 and <i>b</i>=1500 s mm<SUP>-2</SUP>

초록

Objective: To investigate the variability of diffusion- weighted imaging (DWI) interpretation of Prostate Imaging Reporting and Data System (PI-RADS) version 2 (v2) in evaluating prostate cancer (PCa). Methods: 154 patients with PCa underwent multiparametric 3T MRI, followed by radical prostatectomy. DWI with different b values (b = 0, 100, 1000 and 1500 s mm(-2)) was obtained. Using the PI-RADS v2, two radiologists independently scored suspicious lesions in each patient and compared DWI of b = 1000 (DWI1000) with 1500 (DWI1500) s mm(-2). Results: On DWI1000 and DWI1500, the intermethod and interobserver agreements of DWI scores were excellent in all patients (kappa >= 0.873). In each peripheral zone and transition zone DWI scores, both observers showed excellent intermethod agreement between DWI1000 and DWI1500 (kappa >= 0.897), and interobserver agreement for DWI1000 and DWI1500 was good to excellent (kappa >= 0.796). For estimating clinically significant cancer, the area under receiver operating characteristics curves of DWI1000 and DWI1500 were 0.710 and 0.724 for observer 1 (p = 0.11), and 0.649 and 0.656 for observer 2 (p = 0.12), respectively. Conclusion: The PI-RADS v2 scoring at 3T shows excellent agreement between DWI1000 and DWI1500 in evaluating PCa, with excellent inter-observer agreement. Advance in knowledge: DWI using b = 1000 s mm(-2) instead of b = 1500 s mm(-2) reduces examination time or image distortion, with improved the signal-to-noise ratio. excellent intermethod agreement between DWI1000 and DWI1500 (kappa >= 0.897), and interobserver agreement for DWI1000 and DWI1500 was good to excellent (kappa >= 0.796). For estimating clinically significant cancer, the area under receiver operating characteristics curves of DWI1000 and DWI1500 were 0.710 and 0.724 for observer 1 (p = 0.11), and 0.649 and 0.656 for observer 2 (p = 0.12), respectively. Conclusion: The PI-RADS v2 scoring at 3T shows excellent agreement between DWI1000 and DWI1500 in evaluating PCa, with excellent inter-observer agreement. Advance in knowledge: DWI using b = 1000 s mm(-2) instead of b = 1500 s mm(-2) reduces examination time or image distortion, with improved the signal-to-noise ratio.

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