ArticleEuropean radiology2025
PI-QUAL version 2 image quality categorisation and inter-reader agreement compared to version 1.
Article in European radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Optimal Selection of the Effective Echo Time (TEJournal of magnetic resonance imaging : JMRI · 2026Article
- The bMRI-QUAL scoring system: an important first step toward standardizing breast MRI quality.European radiology · 2026Article
- Prostate MRI quality improvement: a Roadmap from the ESUR Prostate MRI Working Group.European radiology · 2026Review
- Integrating Artificial Intelligence into Prostate MR Imaging: Technical Foundations, Clinical Applications, and Workflow Implications.Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine · 2026Review
- Diffusion-weighted Imaging Distortion in Prostate MRI: A Cross-sectional Study Comparing Supine and Prone Positioning.Investigative radiology · 2026Article
- Real-world Inter-rater Agreement of PI-QUAL Version 2 for Prostate Magnetic Resonance Imaging Quality Assessment and Its Association with Diagnostic Accuracy.European urology open science · 2026Article
- Prostate MRI Quality Assessment: PI-QUAL and Factors Influencing Image Quality.Journal of the Korean Society of Radiology · 2025Review
- Multicenter analysis for inter reader agreement of PIQUAL score v2 for basic readers in prostate MRI.Scientific reports · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectivesProstate imaging quality (PI-QUAL) was developed to standardise the evaluation of prostate MRI quality and has recently been updated to version 2. This study aims to assess inter-reader agreement for PI-QUAL v1 and v2 scores and investigates changes in MRI quality score categories. MATERIALS AND
methodsThe study retrospectively analysed 350 multiparametric MRI (mpMRI) scans. Two expert uroradiologists independently assessed mpMRI quality using PI-QUAL v1 and v2 guidelines. Biparametric MRI (bpMRI) categorisation based on PI-QUAL v2 included only T2WI and diffusion-weighted imaging (DWI) results. Inter-reader agreement was determined using percentage agreement and kappa, and categorisation comparisons were made using the chi-square test.
resultsSubstantial inter-reader agreement was observed for the overall PI-QUAL v1 score (κ = 0.64) and moderate agreement for v2 mpMRI (κ = 0.54) and v2 bpMRI scores (κ = 0.57). Inter-reader agreements on individual sequences were similar between v1 and v2 (kappa for individual sequences: T2WI, 0.46 and 0.49; DWI, 0.66 and 0.70; DCE, 0.71 and 0.61). Quality levels shifted from predominantly "optimal" in v1 (65%) down to "acceptable" using v2 (55%); p < 0.001. The addition of DCE increased the proportion of cases with at least "adequate" quality at mpMRI (64%) compared to bpMRI (30%); p < 0.001.
conclusionThis study shows consistent inter-reader agreement between PI-QUAL v1 and v2, encompassing overall and individual sequence categorisation. A notable shift from "optimal" to "acceptable" quality was demonstrated when moving from v1 to v2, with DCE tending improving quality from "inadequate" (bpMRI) to "acceptable" (mpMRI). KEY POINTS: Question What are the agreement levels of image quality of prostate MRI by using PI-QUAL v1 and v2? Findings Inter-reader agreement based on PI-QUAL v1 and v2 is comparable. Dynamic contrast enhancement (DCE) enables an overall shift from inadequate quality (at bpMRI) to acceptable quality (mpMRI). Clinical relevance The inter-reader agreement on PI-QUAL v1 and v2 is equivalent. PI-QUAL v2 assesses prostate bpMRI as well as mpMRI quality. Transitioning from inadequate to acceptable between v2-bpMRI and v2-mpMRI highlights the role of DCE as an "image quality safety net."
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