Comparing Prostate Imaging-Reporting and Data System Version 2 (PI-RADSv2) Category 1 and 2 Groups: Clinical Implication of Negative Multiparametric Magnetic Resonance Imaging

Comparing Prostate Imaging-Reporting and Data System Version 2 (PI-RADSv2) Category 1 and 2 Groups: Clinical Implication of Negative Multiparametric Magnetic Resonance Imaging:



Objectives. To evaluate the clinicopathological differences between Prostate Imaging-Reporting and Data System (PI-RADS) version 2 (v2) category 1 and 2 groups. Materials and Methods. We retrospectively reviewed our two institutional clinical databases: (1) transrectal ultrasound (TRUS)/magnetic resonance imaging (MRI) fusion biopsy cohort () and (2) radical prostatectomy (RP) cohort (). Subsequently, we performed comparative analyses between PI-RADSv2 category 1 and 2 groups. Clinically significant prostate cancer (csPCa) was defined as the presence of Gleason score in a single biopsy core, and adverse pathology (AP) was defined as high-grade (primary Gleason pattern 4 or any pattern 5) and/or non-organ-confined disease (pT3/N1). We also performed multivariate logistic regression analyses for AP. Results. In the TRUS/MRI fusion biopsy cohort, no significant differences in detection rates of all cancer (18.2% vs. 29.0%, respectively, ) or csPCa (9.1% vs. 9.9%, respectively, ) were observed between PI-RADSv2 category 1 and 2 groups. There were no significant differences in pathologic outcomes including Gleason score (, 21.2% vs. 29.9%, respectively, ) or detection rate of AP (27.3% vs. 33.8%, respectively, ) between the two groups in the RP cohort either. PI-RADSv2 category 1 or 2 had no significant association with AP, even in univariate analysis ().Conclusions. PI-RADSv2 categories 1 and 2 had similar performance to predict clinicopathological outcomes. Consequently, these two categories may be unified into a single category. Negative mpMRI does not guarantee the absence of AP, as with csPCa.