Comparing Prostate Imaging-Reporting and Data System Version 2 (PI-RADSv2)‎ Category 1 and 2 Groups: Clinical Implication of Negative Multiparametric Magnetic Resonance Imaging

الملخص EN

Objectives.

To evaluate the clinicopathological differences between Prostate Imaging-Reporting and Data System (PI-RADS) version 2 (v2) category 1 and 2 groups.

Materials and Methods.

We retrospectively reviewed our two institutional clinical databases: (1) transrectal ultrasound (TRUS)/magnetic resonance imaging (MRI) fusion biopsy cohort (n=706) and (2) radical prostatectomy (RP) cohort (n=1403).

Subsequently, we performed comparative analyses between PI-RADSv2 category 1 and 2 groups.

Clinically significant prostate cancer (csPCa) was defined as the presence of Gleason score GS≥3+4 in a single biopsy core, and adverse pathology (AP) was defined as high-grade (primary Gleason pattern 4 or any pattern 5) and/or non-organ-confined disease (pT3/N1).

We also performed multivariate logistic regression analyses for AP.

Results.

In the TRUS/MRI fusion biopsy cohort, no significant differences in detection rates of all cancer (18.2% vs.

29.0%, respectively, P=0.730) or csPCa (9.1% vs.

9.9%, respectively, P=0.692) were observed between PI-RADSv2 category 1 and 2 groups.

There were no significant differences in pathologic outcomes including Gleason score (≥4+3, 21.2% vs.

29.9%, respectively, P=0.420) or detection rate of AP (27.3% vs.

33.8%, respectively, P=0.561) between the two groups in the RP cohort either.

PI-RADSv2 category 1 or 2 had no significant association with AP, even in univariate analysis (P=0.299).

Conclusions.

PI-RADSv2 categories 1 and 2 had similar performance to predict clinicopathological outcomes.

Consequently, these two categories may be unified into a single category.

Negative mpMRI does not guarantee the absence of AP, as with csPCa.