ArticleInvestigative and clinical urology2025
Enhancement of inter-/intra-reader agreement using the Prostate Imaging Reporting and Data System version 2.1 for prostate cancer detection in magnetic resonance imaging/transrectal ultrasound software fusion prostate biopsy.
Article in Investigative and clinical urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- An Assessment of PI-RADS v2.1: Inter-Reader Agreement, Diagnostic Accuracy, and the Added Value of PSA Density in Prostate Cancer Prediction.Diagnostics (Basel, Switzerland) · 2026Article
- Omitting biopsy in Prostate Imaging Reporting and Data System 3? The role of Stockholm3 and prostate-specific antigen density findings from a prospective Swiss non-referral cohort.Prostate international · 2026Article
- Differential detection rates of clinically significant prostate cancer in transition zone versus peripheral zone lesions: Implications for transperineal magnetic resonance imaging-targeted biopsy strategy.Prostate international · 2026Article
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5 authors.
Funding
Abstract
purposeThis study evaluated inter-/intra-reader agreement with the Prostate Imaging Reporting and Data System (PI-RADS) version 2.1 to improve the detection rate of prostate cancer. MATERIALS AND
methodsWe enrolled 210 patients who underwent multiparametric magnetic resonance imaging (mpMRI) for clinically suspected or diagnosed prostate cancer. Four readers, including two urologists, viewed patients' mpMRI and scored PI-RADS between two sessions, including the time for feedback and training after the first reading session. Inter- and intra-reader agreements were evaluated using Fleiss' kappa coefficient (κ), agreement coefficient 1 (AC1), and percentage of agreement (PA).
resultsThe overall inter-reader agreement between all readers was moderate (κ=0.466, AC1=0.522, and PA=0.610). The overall inter-reader agreement improved in the second session. The agreement for peripheral zone (PZ) lesions was higher than that for transitional zone (TZ) lesions. At a PI-RADS cut-off of 4, the agreement for PZ lesions was almost perfect (PA=0.888) and higher than that for TZ lesions. The inter-reader agreement for lesions with a PI-RADS ≥4 and Gleason score ≥7 was almost perfect (AC1=0.960 and PA=0.964). The intra-reader agreement for lesions overall and PI-RADS ≥4 lesions were substantial (AC1=0.601) and almost perfect (PA=0.876), respectively.
conclusionsReaders achieved moderate agreement for PI-RADS version 2.1 and benefitted from training sessions. Feedback, training, and multidisciplinary discussions also improved inter-reader agreement. Our study can provide guidance, updates, and further steps for the standardization and improvement of PI-RADS scoring.
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