Prostate cancer recurrence scoring system yields 'promising' results
An international panel of experts recently developed and validated a reporting assessment scoring system that analyzes the location and extent of prostate cancer recurrence.
To test the diagnostic accuracy of the Prostate Imaging for Recurrence Reporting (PI-RR) assessment scores, radiologists analyzed multiparametric MRIs of 100 men with biochemical recurrence (BCR) after they had been treated via radiation therapy (RT) or radical prostatectomy (RP).
“MRI is recommended by European guidelines as the first-line tool in patients experiencing BCR after radiation therapy (RT). However, the lack of a standardized approach to MRI, the limited sample sizes of published studies, and the low proportion of studies with pathologic verification have resulted in uncertainties in terms of MRI accuracy and relative benefit,” corresponding author Valeria Panebianco, from the Department of Radiological Sciences, Oncology and Pathology at Sapienza University in Rome and co-authors explained.
In the study, experts found that the scores (above or below a cutoff of three) reliably fulfilled the need for a structured and reproducible reporting and classification system for prostate cancer recurrence. This was based on the assessment scores that four radiologists assigned to each patient after analyzing their MRI scans.
Across all four readers, an area under the receiver operating characteristic curve (AUC) of .77 to .92 was observed for patients who had been treated with radiation therapy. Similar numbers were achieved in the group of men who had undergone radical prostatectomy, coming in at .80 to .88, respectively.
For both RT and RP groups, the four radiologists displayed excellent interreader agreement with an intraclass correlation coefficient of 0.87, the authors noted, describing their results as “promising.”
“Taken together, our data show that PI-RR retains the accuracy of MRI for the detection of local tumor recurrence while at the same time providing a structured assessment score,” the authors wrote. “With further multidisciplinary efforts to refine its application, PI-RR may become an important tool to guide treatment.”
The authors acknowledged the study’s limitations, which include a small sample size, and concluded that additional prospective research is necessary before their results can be considered definitive.
The full study can be viewed in Radiology.
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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.