@Article{,
AUTHOR = {Nachiketh Soodana-Prakash, R. Patricia Castillo, Isildinha M. Reis, Radka Stoyanova, Deukwoo Kwon, Maria C. Velasquez, Bruno Nahar, Pratik Kannabur, Taylor A. Johnson, Sanjaya K. Swain, Natalie Ben-Yakar, Vivek Venkatramani, Chad Ritch, Ramgopal Satyanarayana, Mark L. Gonzalgo, Dipen J. Parekh, Leonardo Bittencourt, Sanoj Punnen},
TITLE = {Validation of dominant and secondary sequence utilization in PI-RADS v2 for classifying prostatic lesions},
JOURNAL = {Canadian Journal of Urology},
VOLUME = {26},
YEAR = {2019},
NUMBER = {3},
PAGES = {9763--9768},
URL = {http://www.techscience.com/CJU/v26n3/60643},
ISSN = {1488-5581},
ABSTRACT = {<b>Introduction:</b> To assess the secondary sequence rule in The Prostate Imaging Reporting Data System (PI-RADS) version 2 by comparing the detection of Grade group 1+ (GG1+) and 2+ (GG2+) cancers in PI-RADS 3, an upgraded PI-RADS 4, and true (non-upgraded) PI-RADS 4 targets.<br/>
<b>Materials and methods:</b> We analyzed a total of 589 lesions scored as PI-RADS 3 or 4 obtained from 434 men who underwent mpMRI-US fusion biopsy from September 2015 to November 2017 for evaluation of GG1+ and GG2+ prostate cancer. PI-RADS 4 lesions were differentiated into those that were “upgraded” to PI-RADS 4 based on the secondary sequence and those that were “true” PI-RADS 4 based on the dominant sequence.<br/>
<b>Results:</b> The odds of detecting a GG2+ cancer was significantly higher for an upgraded 4 (peripheral zone (PZ): OR 5.06, 95% CI 2.04-12.54, p < 0.001, transitional zone (TZ): OR 3.08, 95% CI 1.04-9.08, p = 0.042) and true 4 (PZ: OR 5.82, 95% CI 3.10-10.94, p < 0.0001, TZ: OR 2.43, 95% CI 1.14-5.18, p = 0.022) lesions compared to PI-RADS 3 lesions. Additionally, we found no difference in the odds of detecting a GG2+ prostate cancer between a true PI-RADS 4 (OR 1.15, 95% CI 0.49-2.71, p = 0.746) and upgraded 4 (referent) in the PZ. Similar non-significance was noted between true 4 (OR 0.79, 95% CI 0.26-2.38, p = 0.674) and upgraded 4 lesions in the TZ for detection of GG2+ cancers.<br/>
<b>Conclusions:</b> Upgraded PI-RADS 4 and true 4 targets have a higher odds of detecting GG1+ and GG2+ compared to PI-RADS 3 in the PZ and TZ. Our findings validate the revised scoring system for PI-RADS.},
DOI = {}
}