In prostatic transition zone lesions (PI-RADS v2.1): which subgroup should be biopsied?

• Published in: Egyptian Journal of Radiology and Nuclear Medicine Vol. 52; no. 1; pp. 192 - 11
• Main Authors: An, Jihae, Kim, Young Joong, Seo, Jae Young, Hwang, Cheol Mog, Oh, Dong Hyun, Lee, Mu-Sik, Kim, Keum Won
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 03.08.2021; Springer; Springer Nature B.V; SpringerOpen
• Subjects: Biopsy; Imaging; Magnetic resonance imaging; Medicine; Medicine & Public Health; Multiparametric magnetic resonance imaging; Nuclear Medicine; Patients; Prostate cancer; Prostate Imaging and Reporting Data System; Radiology; Netherlands; Multiparametric magnetic resonance imaging; Prostate cancer; Prostate Imaging and Reporting Data System
• ISSN: 0378-603X; 2090-4762
• DOI: 10.1186/s43055-021-00543-9

Background The study aimed to compare the diagnostic performance of T2-weighted imaging (T2WI) score 3 transition zone (TZ) lesions between Prostate Imaging and Reporting Data System (PI-RADS) v2.1 and modified PI-RADS v2.1-B. Results Among TZ lesions ( n = 78), 47 (60.0%) had T2WI score of 3, and 16 of the 47 (34.0%) were malignant. The rate of malignancy was 8.8% in PI-RADS category 3A, 100% in PI-RADS category 3B, and 100% in PI-RADS category 4. The apparent diffusion coefficient value of PI-RADS category 3B (0.934 ± 0.158 × 10 −3 mm 2 /s) showed significant difference with that of PI-RADS category 3A (1.098 ± 0.146 × 10 −3 mm 2 /s) but none with PI-RADS category 4 (0.821 ± 0.091 × 10 −3 mm 2 /s). There was no significant difference in the sensitivity and negative predictive value of PI-RADS v2.1 and PI-RADS v2.1-B. Specificity and positive predictive value of modified PI-RADS v2.1-B were much higher than those of PI-RADS v2.1 for both readers ( p < .001). The area under the receiver operating characteristic curve tended to be higher with PI-RADS v2.1-B than with PI-RADS v2.1. Conclusion Biopsy for PI-RADS 3B lesion is necessary due to its superior malignancy potential than that of PI-RADS 3A lesion.