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PI-RADS version 2: Preoperative role in the detection of normal-sized pelvic lymph node metastasis in prostate cancer

 Sung Yoon Park  ;  Su-Jin Shin  ;  Dae Chul Jung  ;  Nam Hoon Cho  ;  Young Deuk Choi  ;  Koon Ho Rha  ;  Sung Joon Hong  ;  Young Taik Oh 
 European Journal of Radiology, Vol.91 : 22-28, 2017 
Journal Title
 European Journal of Radiology 
Issue Date
Aged ; Biopsy, Large-Core Needle ; Humans ; Lymph Node Excision ; Lymph Nodes/diagnostic imaging* ; Lymph Nodes/pathology ; Lymph Nodes/surgery ; Lymphatic Metastasis ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Pelvis ; Preoperative Care/methods* ; Prostate/diagnostic imaging ; Prostate/pathology ; Prostate/surgery ; Prostatectomy ; Prostatic Neoplasms/diagnostic imaging* ; Prostatic Neoplasms/pathology* ; Prostatic Neoplasms/surgery ; Radiology Information Systems* ; Retrospective Studies
Lymph node ; MRI ; PI-RADS ; Prostate cancer
OBJECTIVES: To analyze whether Prostate Imaging Reporting and Data System (PI-RADSv2) scores are associated with a risk of normal-sized pelvic lymph node metastasis (PLNM) in prostate cancer (PCa). MATERIALS AND METHODS: A consecutive series of 221 patients who underwent magnetic resonance imaging and radical prostatectomy with pelvic lymph node dissection (PLND) for PCa were retrospectively analyzed under the approval of institutional review board in our institution. No patients had enlarged (≥0.8cm in short-axis diameter) lymph nodes. Clinical parameters [prostate-specific antigen (PSA), greatest percentage of biopsy core, and percentage of positive cores], and PI-RADSv2 score from two independent readers were analyzed with multivariate logistic regression and receiver operating-characteristic curve for PLNM. Diagnostic performance of PI-RADSv2 and Briganti nomogram was compared. Weighted kappa was investigated regarding PI-RADSv2 scoring. RESULTS: Normal-sized PLNM was found in 9.5% (21/221) of patients. In multivariate analysis, PI-RADSv2 (reader 1, p=0.009; reader 2, p=0.026) and PSA (reader 1, p=0.008; reader 2, p=0.037) were predictive of normal-sized PLNM. Threshold of PI-RADSv2 was a score of 5, where PI-RADSv2 was associated with high sensitivity (reader 1, 95.2% [20/21]; reader 2, 90.5% [19/21]) and negative predictive value (reader 1, 99.2% [124/125]; reader 2, 98.6% [136/138]). However, diagnostic performance of PI-RADSv2 (AUC=0.786-0.788) was significantly lower than that of Briganti nomogram (AUC=0.890) for normal-sized PLNM (p<0.05). The inter-reader agreement was excellent for PI-RADSv2 of 5 or not (weighted kappa=0.804). CONCLUSION: PI-RADSv2 scores may be associated with the risk of normal-sized PLNM in PCa.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
나군호(Rha, Koon Ho) ORCID logo https://orcid.org/0000-0001-8588-7584
박성윤(Park, Sung Yoon)
신수진(Shin, Su Jin)
오영택(Oh, Young Taik) ORCID logo https://orcid.org/0000-0002-4438-8890
정대철(Jung, Dae Chul) ORCID logo https://orcid.org/0000-0001-5769-5083
조남훈(Cho, Nam Hoon) ORCID logo https://orcid.org/0000-0002-0045-6441
최영득(Choi, Young Deuk) ORCID logo https://orcid.org/0000-0002-8545-5797
홍성준(Hong, Sung Joon) ORCID logo https://orcid.org/0000-0001-9869-065X
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