基于第二版前列腺影像报告和数据系统评估前列腺病灶的一致性及准确性的探究

刘　伟; 刘晓航; 汤　伟

doi:10.19401/j.cnki.1007-3639.2018.03.005

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基于第二版前列腺影像报告和数据系统评估前列腺病灶的一致性及准确性的探究

论著 | 更新时间：2026-01-27

- 基于第二版前列腺影像报告和数据系统评估前列腺病灶的一致性及准确性的探究
- The exploration of interobserver agreement and accuracy of Prostate Imaging Reporting and Data System version 2 for the prostate carcinoma
- 中国癌症杂志 2018年28卷第3期页码：197-202
- 作者机构：
  
  1. 复旦大学附属肿瘤医院放射诊断科，复旦大学上海医学院肿瘤学系,上海,200032
  2. 上海市影像医学研究所,上海,200032
- 作者简介：
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2018.03.005
  中图分类号： R737.25
- 网络出版：2018-04-11，
  
  纸质出版：2018-04-11
- 稿件说明：
移动端阅览
刘　伟,刘晓航,汤　伟,等. 基于第二版前列腺影像报告和数据系统评估前列腺病灶的一致性及准确性的探究[J]. 中国癌症杂志, 2018, 28(3): 197-202.

刘　伟, 刘晓航, 汤　伟. The exploration of interobserver agreement and accuracy of Prostate Imaging Reporting and Data System version 2 for the prostate carcinoma[J]. China Oncology, 2018, 28(3): 197-202.
刘　伟,刘晓航,汤　伟,等. 基于第二版前列腺影像报告和数据系统评估前列腺病灶的一致性及准确性的探究[J]. 中国癌症杂志, 2018, 28(3): 197-202. DOI： 10.19401/j.cnki.1007-3639.2018.03.005.

刘　伟, 刘晓航, 汤　伟. The exploration of interobserver agreement and accuracy of Prostate Imaging Reporting and Data System version 2 for the prostate carcinoma[J]. China Oncology, 2018, 28(3): 197-202. DOI： 10.19401/j.cnki.1007-3639.2018.03.005.

摘要

背景与目的：随着前列腺多参数MR成像技术的发展，影像学在前列腺病灶诊断、恶性度评估及疗效评估等方面均表现出一定的临床意义。但扫描序列增多，且在前列腺不同区域、不同序列所占的权重并不一样，给临床工作带来了一定的负担，基于此基础上的第二版前列腺影像报告和数据系统（Prostate ImagingReporting and Data System version 2，PI-RADS V2）应运而生。为推广PI-RADS V2，本研究就其对前列腺病灶评估的一致性及准确性进行探究。方法：回顾性分析98例符合PI-RADS V2评估要求并有病理资料的患者，共141个病灶。邀请两位不同年资的影像学医师独立评估病灶。采用kappa系数评估两名医师PI-RADS V2分类评分的一致性。利用受试者工作特征（receiver operating characteristic，ROC）曲线方法来分析两名医师诊断出Gleason score≥7的病灶的准确性，并分别计算出各ROC曲线的cut-off值来确定PI-RADS V2评分的最佳界值。结果：对于PI-RADS V2≥3分的病灶，两名医师对外周带病灶评估一致性较好（非外周带和外周带kappa值分别为0.668和0.769）。对于PI-RADS V2≥4分的病灶，其评估一致性更好（非外周带和外周带kappa值分别为0.710和0.843）。影像学医师1、2诊断出Gleason score≥7的病灶的ROC曲线的曲线下面积（area under curve，AUC）分别为0.816、0.792，且非外周带的AUC均比外周带的高（AUC1：0.886 vs 0.791；AUC2：0.791 vs 0.730）。另外，两名医师在评估外周带及非外周带病灶良恶性的最佳PI-RADS V2评分界值均为3分。结论：PI-RADS V2评价前列腺病灶具有较好的一致性及准确性。PI-RADS V2可能更适合非外周带病灶的评估，尚需进一步验证。

Abstract

Background and purpose: With the development of multi-parametric MR imaging techniques for detection of prostate carcinoma

medical imaging has shown the promising value in diagnosis

prediction of aggressiveness and evaluation of responses to different treatments. However

the increase of scanning sequences and the different weight of sequences in different regions of prostate put additional burden on diagnosticians

and thus the Prostate Imaging Reporting and Data System version 2 (PI-RADS V2) is generated. For popularizing PI-RADS V2

we performed this study to investigate interobserver agreement and accuracy in diagnosing prostate lesions. Methods: We retrospectively analyzed 98 patients with 141 prostate carcinoma lesions confirmed by biopsy and/or surgery who met the conditions of PI-RADS V2 assessment. Two readers independently assigned a PI-RADS V2 assessment category to the lesions. The Cohen’s kappa statistic was used to quantify interobserver agreement. The area under the receiver operating characteristic (ROC) curve (AUC) was calculated to determine reader accuracy for the detection of clinically significant prostate cancer (Gleason score ≥7). Simultaneously

the cutoff value of all ROCs were calculated

which would be regarded as the optimal value to define the prostate lesions as benign or malignant foci. Results: When a PI-RADS V2 assessment category ≥3 was considered positive

the agreement between readers was good for nonperipheral zone lesions (kappa=0.668) and peripheral zone lesions (kappa=0.769). When a PI-RADS V2 assessment category ≥4 was considered positive

the agreement was better for non-peripheral zone lesions (kappa=0.710) and excellent for peripheral zone lesions (kappa=0.843). The AUCs for readers 1 and 2 were 0.816 and 0.792

and had no significant difference. The AUCs were greater for non-peripheral zone lesions than for peripheral zone lesions (AUC1: 0.886 vs 0.791; AUC2: 0.791 vs 0.730). Additionally

the cutoff value of all ROC curves was 3. Conclusion: Two experienced readers were able to accurately identify patients with clinically significant prostate cancer using PI-RADS V2 with good interobserver agreement. PI-RADS V2 may be more suitable for non-peripheral zone lesions

which need further investigation.

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