AUTHOR=Wen Jing , Ji Yugang , Han Jing , Shen Xiaocui , Qiu Yi 

TITLE=Inter-reader agreement of the prostate imaging reporting and data system version v2.1 for detection of prostate cancer: A systematic review and meta-analysis

JOURNAL=Frontiers in Oncology

VOLUME=12

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.1013941

DOI=10.3389/fonc.2022.1013941

ISSN=2234-943X

ABSTRACT=<sec><title>Objectives</title><p>We aimed to systematically assess the inter-reader agreement of the Prostate Imaging Reporting and Data System Version (PI-RADS) v2.1 for the detection of prostate cancer (PCa).</p></sec><sec><title>Methods</title><p>We included studies reporting inter-reader agreement of different radiologists that applied PI-RADS v2.1 for the detection of PCa. Quality assessment of the included studies was performed with the Guidelines for Reporting Reliability and Agreement Studies. The summary estimates of the inter-reader agreement were pooled with the random-effect model and categorized (from slight to almost perfect) according to the kappa (<italic>κ</italic>) value. Multiple subgroup analyses and meta-regression were performed to explore various clinical settings.</p></sec><sec><title>Results</title><p>A total of 12 studies comprising 2475 patients were included. The pooled inter-reader agreement for whole gland was <italic>κ</italic>=0.65 (95% CI 0.56-0.73), and for transitional zone (TZ) lesions was <italic>κ</italic>=0.62 (95% CI 0.51-0.72). There was substantial heterogeneity presented throughout the studies (<italic>I</italic><sup>2</sup>= 95.6%), and meta-regression analyses revealed that only readers’ experience (&lt;5 years vs. ≥5 years) was the significant factor associated with heterogeneity (P&lt;0.01). In studies providing head-to-head comparison, there was no significant difference in inter-reader agreement between PI-RADS v2.1 and v2.0 for both the whole gland (0.64 vs. 0.57, <italic>p</italic>=0.37), and TZ (0.61 vs. 0.59, <italic>p</italic>=0.81).</p></sec><sec><title>Conclusions</title><p>PI-RADS v2.1 demonstrated substantial inter-reader agreement among radiologists for whole gland and TZ lesions. However, the difference in agreement between PI-RADS v2.0 and v2.1 was not significant for the whole gland or the TZ.</p></sec>