ArticleLa Radiologia medica2024
Factors of interobserver variability in prostate tumor MRI delineation: impact of PI-QUAL score.
Article in La Radiologia medica, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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8 authors.
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Abstract
backgroundProstate cancer ranks as the second most common cancer in men worldwide. Dose escalation to the tumor and/or the prostate improves biochemical recurrence-free survival. However, interobserver variability in lesion contouring poses a significant limitation to such therapeutic approaches. Therefore, a study of factors influencing this variability is necessary. MATERIALS AND
methodsThree independent readers delineated the index prostate lesion (DIL) using T2w and ADC sequences for each patient. Clinical data were retrospectively collected for all participants. Logistic regression analysis was employed to examine the correlation between clinical features and a mean DICE coefficient > 0.7. Features exhibiting a p value < 0.05 on univariate analysis were subjected to multivariate analysis.
resultsThe study comprised 68 patients, with a median DICE coefficient of 0.69 (95% CI 0.65-0.71), wherein 42.6% (29/68) attained a mean DICE > 0.7. Univariate analysis identified the PI-QUAL score, maximum diameter of DIL, and mean DIL volume as significant (p < 0.05) predictors. In multivariate analysis, only the PI-QUAL score (p = 0.008) remained statistically associated with a DICE coefficient > 0.7.
conclusionThe PI-QUAL score emerges as the primary predictive factor for minimizing inter-reader variability in intraprostatic dominant lesion segmentation. These findings underscore the importance of considering PI-QUAL scores when devising focal treatment plans. Adoption of a multi-reader approach involving diverse medical specialists (radiologists, radiotherapists, urologists) is advocated, particularly for MRIs with low PI-QUAL scores. CLINICAL RELEVANCE STATEMENT: Radiotherapy is a major treatment for patients with localized prostate cancer. Dose escalation to the tumor leads to improved cancer control. Precise delineation of the dominant intraprostatic lesion (DIL) remains a limitation to focal treatments. Features influencing inter-reader variability were never evaluated. In this study, we identified that the PI-QUAL score was the sole predictor of the inter-reader delineation variability of the DIL.
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