EURURO Vol. 72 No. 2

Platinum Priority – Review – Prostate Cancer

Editorial by Jelle Barentsz, Maarten de Rooij, Geert Villeirs and Jeffrey Weinreb on pp. 189–191 of this issue

Diagnostic Performance of Prostate Imaging Reporting and Data

System Version 2 for Detection of Prostate Cancer: A Systematic

Review and Diagnostic Meta-analysis

Sungmin Woo

[2_TD$DIFF]

, Chong Hyun Suh

b , c , y

, Sang Youn Kim

a , * ,

Jeong Yeon Cho

a , d ,

Seung Hyup Kim

a , d

Department of Radiology, Seoul National University College of Medicine, Seoul, Korea;

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;

Institute of Radiation Medicine and Kidney Research Institute, Seoul National University Medical Research Center, Seoul, Korea

E U R O P E A N U R O L O G Y 7 2 ( 2 0 1 7 ) 1 7 7 – 1 8 8

ava ilable at

www.sciencedirect.com

journal homepage:

www.eu ropeanurology.com

Article info

Article history:

Accepted January 25, 2017

Associate Editor:

Giacomo Novara

Keywords:

Prostate imaging reporting and

data system version 2

Prostate cancer

Magnetic resonance imaging

Meta-analysis

Abstract

Context:

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.

Objective:

To review the diagnostic performance of PI-RADSv2 for the detection of PCa.

Evidence acquisition:

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.

Evidence synthesis:

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

(

0.01). Multiple subgroup analyses showed consistent results. In six studies per-

forming 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

(

= 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;

= 0.90).

Conclusions:

PI-RADSv2 shows good performance for the detection of PCa. PI-RADSv2

has higher pooled sensitivity than PI-RADSv1 without significantly different specificity.

Patient summary:

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.

These authors contributed equally.

* Corresponding author. Department of Radiology, Seoul National University Hospital, 101 Daehak-

ro, Jongno-gu, Seoul 110-744, Korea. Tel. +82 2 2072 4897; Fax: +82 2 743 6385.

E-mail address:

iwishluv@empas.com

(S.Y. Kim).

http://dx.doi.org/10.1016/j.eururo.2017.01.042

0302-2838/