MP18-11: Impact of Prostate MRI Quality (PI-QUAL) on Clinically Significant Prostate Cancer Detection Rates
Friday, May 3, 2024 3:30 PM to 5:30 PM · 2 hr. (US/Central)
302B
Abstract
Information
Full Abstract and Figures
Author Block
Jason M Scovell, Kassandra Zaila Ardines*, Ross Liao, Kailash Singh, Robert Abouassaly, Christopher Weight, Andrei Purysko, Ryan Ward, Zeyad Schwen, Cleveland, OH
Introduction
Multiparametric magnetic resonance imaging (mpMRI) is a core component in prostate cancer (PCa) diagnosis and treatment management decision-making. The widespread dissemination of mpMRI has led to significant variability in performance for the detection of clinically significant PCa (csPCa), partly due to MRI quality variability. The PI-QUAL system was developed to score the overall quality of a prostate MRI scan, which some studies have shown to be associated with diagnostic accuracy. We sought to determine the impact PI-QUAL scoring has on performance characteristics for patients with PI-RADS = 3 lesions who underwent MRI fusion biopsy.
Methods
We analyzed our prospectively annotated prostate mpMRI cohort of patients who underwent mpMRI at our center between 3/2023 - 10/2023 and had available MRI, PI-QUAL, and MRI Fusion prostate biopsy pathology data. We evaluated rates of csPCa (GG2+) based on PI-QUAL and PI-RADS (v2.1) and further assessed the impact of individual sequence quality (T2, DWI, DCE), lesion location (TZ, PZ), and rates of targeted vs systematic detected csPCa. Statistics were performed with Chi-Square tests.
Results
A total of 234 patients with 296 PI-RADS ³ 3+ lesions patients had available data and were included for analysis. There was no definitive impact of PI-QUAL score on csPCa rates across PI-RADS scores (Table 1a) and between prostate zones (TZ vs PZ, Table 1b) (p>0.05). Additionally, the adequacy of PI-QUAL phase (T2, DWI, DCE) did not impact detection rates based on PI-RADS score (p>0.05). There was no difference in the proportion of patients diagnosed with GG2+ prostate cancer across PI-QUAL scores. Comparing targeted vs systematic biopsies, csPCa (GG2+) was detected within the target in 48% of patients while an additional 32% had a GG2+ detected on systematic biopsy outside the target zone. Rates of systematic-only detected csPCa were not significantly different based on PI-QUAL score.
Conclusions
Overall, PI-QUAL score and phase-specific (T2, DWI, DCE) quality did not have a significant impact on rates of csPCa based on PI-RADS score or prostate zones. Similarly, the rates of systematic-only detected csPCa were not impacted by PI-QUAL score. These findings highlight the resilience of mpMRI for detecting csPCa as not being significantly impacted by fluctuations in mpMRI quality.
Source Of Funding
None
Author Block
Jason M Scovell, Kassandra Zaila Ardines*, Ross Liao, Kailash Singh, Robert Abouassaly, Christopher Weight, Andrei Purysko, Ryan Ward, Zeyad Schwen, Cleveland, OH
Introduction
Multiparametric magnetic resonance imaging (mpMRI) is a core component in prostate cancer (PCa) diagnosis and treatment management decision-making. The widespread dissemination of mpMRI has led to significant variability in performance for the detection of clinically significant PCa (csPCa), partly due to MRI quality variability. The PI-QUAL system was developed to score the overall quality of a prostate MRI scan, which some studies have shown to be associated with diagnostic accuracy. We sought to determine the impact PI-QUAL scoring has on performance characteristics for patients with PI-RADS = 3 lesions who underwent MRI fusion biopsy.
Methods
We analyzed our prospectively annotated prostate mpMRI cohort of patients who underwent mpMRI at our center between 3/2023 - 10/2023 and had available MRI, PI-QUAL, and MRI Fusion prostate biopsy pathology data. We evaluated rates of csPCa (GG2+) based on PI-QUAL and PI-RADS (v2.1) and further assessed the impact of individual sequence quality (T2, DWI, DCE), lesion location (TZ, PZ), and rates of targeted vs systematic detected csPCa. Statistics were performed with Chi-Square tests.
Results
A total of 234 patients with 296 PI-RADS ³ 3+ lesions patients had available data and were included for analysis. There was no definitive impact of PI-QUAL score on csPCa rates across PI-RADS scores (Table 1a) and between prostate zones (TZ vs PZ, Table 1b) (p>0.05). Additionally, the adequacy of PI-QUAL phase (T2, DWI, DCE) did not impact detection rates based on PI-RADS score (p>0.05). There was no difference in the proportion of patients diagnosed with GG2+ prostate cancer across PI-QUAL scores. Comparing targeted vs systematic biopsies, csPCa (GG2+) was detected within the target in 48% of patients while an additional 32% had a GG2+ detected on systematic biopsy outside the target zone. Rates of systematic-only detected csPCa were not significantly different based on PI-QUAL score.
Conclusions
Overall, PI-QUAL score and phase-specific (T2, DWI, DCE) quality did not have a significant impact on rates of csPCa based on PI-RADS score or prostate zones. Similarly, the rates of systematic-only detected csPCa were not impacted by PI-QUAL score. These findings highlight the resilience of mpMRI for detecting csPCa as not being significantly impacted by fluctuations in mpMRI quality.
Source Of Funding
None
Sessions
MP18: Imaging/Uroradiology I
302B