ArticleAbdominal radiology (New York)2018
Evaluating the size criterion for PI-RADSv2 category 5 upgrade: is 15 mm the best threshold?
Article in Abdominal radiology (New York), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 17 citations in OpenAlex.
- ProLesA-Net: A multi-channel 3D architecture for prostate MRI lesion segmentation with multi-scale channel and spatial attentions.Patterns (New York, N.Y.) · 2024Article
- Extra-prostatic extension grading system: correlation with MRI features and integration of capsular enhancement sign for "enhanced" detection of T3a lesions.The British journal of radiology · 2024Article
- Higher Preoperative Maximum Standardised Uptake Values (SUVDiagnostics (Basel, Switzerland) · 2023Article
- Utilizing lesion diameter and prostate specific antigen density to decide on magnetic resonance imaging guided confirmatory biopsy of prostate imaging reporting and data system score three lesions in African American prostate cancer patients managed with active surveillance.International urology and nephrology · 2022Article
- Comparison of Likert and PI-RADS version 2 MRI scoring systems for the detection of clinically significant prostate cancer.The British journal of radiology · 2020Article
- Effect of observation size and apparent diffusion coefficient (ADC) value in PI-RADS v2.1 assessment category 4 and 5 observations compared to adverse pathological outcomes.European radiology · 2020Article
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Authors and funding
11 authors at 3 institutions in 2 countries.
Funding
Abstract
purposeThe purpose of the study was to determine if the ≥ 15 mm threshold currently used to define PIRADS 5 lesions is the optimal size threshold for predicting high likelihood of clinically significant (CS) cancers. MATERIALS: Three hundred and fifty-eight lesions that may be changed from category 4 to 5 or vice versa on the basis of the size criterion (category 4: n = 288, category 5: n = 70) from 255 patients were evaluated. Kendall's tau-b statistic accounting for inter-lesion correlation, generalized estimation equation logistic regression, and receiver operating curve analysis evaluated two lesion size-metrics (lesion diameter and relative lesion diameter-defined as lesion diameter/prostate volume) for ability to identify CS (Gleason grade ≥ 3 + 4) cancer at targeted biopsy. Optimal cut-points were identified using the Youden index. Analyses were performed for the whole prostate (WP) and zone-specific sub-cohorts of lesions in the peripheral and transition zones (PZ and TZ).
resultsLesion diameter showed a modest correlation with Gleason grade (WP: τB = 0.21, p < 0.0001; PZ: τB = 0.13, p = 0.02; TZ: τB = 0.32, p = 0.001), and association with CS cancer detection (WP: AUC = 0.63, PZ: AUC = 0.59, TZ: AUC = 0.74). Empirically derived thresholds (WP: 14 mm, PZ: 13 mm, TZ: 16 mm) performed similarly to the current ≥ 15 mm standard. Lesion relative lesion diameter improved identification of CS cancers compared to lesion diameter alone (WP: τB = 0.30, PZ: τB = 0.24, TZ: τB = 0.42, all p < 0.0001). AUC also improved for WP and PZ lesions (WP: AUC = 0.70, PZ: AUC = 0.68, and TZ: AUC = 0.74).
conclusionsThe current ≥ 15 mm diameter threshold is a reasonable delineator of PI-RADS category 4 and category 5 lesions in the absence of extraprostatic extension to predict CS cancers. Additionally, relative lesion diameter can improve identification of CS cancers and may serve as another option for distinguishing category 4 and 5 lesions.
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