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Role of the Prostate Imaging Quality PI-QUAL Score for Prostate Magnetic Resonance Image Quality in Pathological Upstaging After Radical Prostatectomy: A Multicentre European Study

PI-QUAL (Prostate Imaging Quality) is a new score used to standardize the assessment of multiparametric magnetic resonance imaging (mpMRI). We provide further evidence that PI-QUAL has clinical implications. mpMRI of insufficient quality, defined as PI-QUAL

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Published in:	European urology open science (Online) 2023-01, Vol.47, p.94-101
Main Authors:	Windisch, Olivier, Benamran, Daniel, Dariane, Charles, Favre, Martina Martins, Djouhri, Mehdi, Chevalier, Maxime, Guillaume, Bénédicte, Oderda, Marco, Gatti, Marco, Faletti, Riccardo, Colinet, Valentin, Lefebvre, Yolene, Bodard, Sylvain, Diamand, Romain, Fiard, Gaelle
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Language:	English
Subjects:	Prostate Cancer
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creator	Windisch, Olivier Benamran, Daniel Dariane, Charles Favre, Martina Martins Djouhri, Mehdi Chevalier, Maxime Guillaume, Bénédicte Oderda, Marco Gatti, Marco Faletti, Riccardo Colinet, Valentin Lefebvre, Yolene Bodard, Sylvain Diamand, Romain Fiard, Gaelle
description	PI-QUAL (Prostate Imaging Quality) is a new score used to standardize the assessment of multiparametric magnetic resonance imaging (mpMRI). We provide further evidence that PI-QUAL has clinical implications. mpMRI of insufficient quality, defined as PI-QUAL
doi_str_mv	10.1016/j.euros.2022.11.013
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We provide further evidence that PI-QUAL has clinical implications. mpMRI of insufficient quality, defined as PI-QUAL <3, results in a higher rate of pathological upstaging. Increasing use of multiparametric magnetic resonance imaging (mpMRI) has come with heterogeneity in image quality. The Prostate Imaging Quality (PI-QUAL) score is under scrutiny to assess its usefulness in predicting clinical outcomes. To compare upstaging of localized disease on mpMRI (mrT2) to locally invasive disease in radical prostatectomy (RP) specimens (≥pT3a) in relation to PI-QUAL. Patients treated with RP between 2015 and 2020 who underwent 1.5–3-T mpMRI within 6 mo before surgery and had systematic and mpMRI-US targeted biopsies were included. mpMRI scans were retrospectively assigned a PI-QUAL score, and prospectively acquired Prostate Imaging-Recording and Data System (PI-RADS) scores (version 2.0 or 2.1) were used. PI-QUAL scores were categorized as nondiagnostic (PI-QUAL <3), sufficient (PI-QUAL 3), or optimal (PI-QUAL >3). We assessed the relationship between the PI-QUAL score and upstaging using multivariate logistic regression. mpMRI, clinical, and pathological findings were compared using χ2 tests and analysis of variance. We identified 351 patients, of whom 40 (11.4%) had PI-QUAL <3, 57 (16.3%) had PI-QUAL 3, and 254 (72.3%) had PI-QUAL >3 scores. The distribution of PI-QUAL <3 (0–33.6%; p < 0.001) and PI-QUAL >3 (37.3–100%; p < 0.001) scores varied widely among centers. PI-QUAL ≥3 in comparison to PI-QUAL <3 was associated with a lower rate of upstaging (19% vs 35%; p = 0.02), greater detection of mrT3a and mrT3b prostate cancer (17.0% vs 2.5%; p = 0.016), a higher rate of PI-RADS 5 lesions (47% vs 27.5%; p = 0.002), a higher number of suspicious lesion (PI-RADS ≥3: 34.7% vs 15%; p = 0.012), and higher detection rates for aggregated (50.7% vs 22.5%; p = 0.001) and late (21.2% vs 0%; p < 0.001) extraprostatic extension. On multivariate analysis, PI-QUAL<3 was associated with more frequent upstaging in the RP specimen (odds ratio 3.4; p = 0.01). In comparison to PI-QUAL ≥3, PI-QUAL <3 was significantly associated with a higher rate of upstaging from organ-confined disease on mpMRI to locally advanced disease on pathology, lower detection rates for PI-RADS 5 lesions and extraprostatic extension, and a lower number of suspicious lesions. Poor image quality for magnetic resonance imaging (MRI) scans of the prostate is associated with underestimation of the stage of prostate cancer.]]></description><identifier>ISSN: 2666-1683</identifier><identifier>ISSN: 2666-1691</identifier><identifier>EISSN: 2666-1683</identifier><identifier>DOI: 10.1016/j.euros.2022.11.013</identifier><identifier>PMID: 36601048</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Prostate Cancer</subject><ispartof>European urology open science (Online), 2023-01, Vol.47, p.94-101</ispartof><rights>2022 The Authors</rights><rights>2022 The Authors.</rights><rights>2022 The Authors 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c525t-711828d703a98536af4991058e3082b27bdadc5f25811ee8bb2f4495ddfbd9f13</citedby><cites>FETCH-LOGICAL-c525t-711828d703a98536af4991058e3082b27bdadc5f25811ee8bb2f4495ddfbd9f13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9806708/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S266616832202701X$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,3547,27922,27923,45778,53789,53791</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36601048$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Windisch, Olivier</creatorcontrib><creatorcontrib>Benamran, Daniel</creatorcontrib><creatorcontrib>Dariane, Charles</creatorcontrib><creatorcontrib>Favre, Martina Martins</creatorcontrib><creatorcontrib>Djouhri, Mehdi</creatorcontrib><creatorcontrib>Chevalier, Maxime</creatorcontrib><creatorcontrib>Guillaume, Bénédicte</creatorcontrib><creatorcontrib>Oderda, Marco</creatorcontrib><creatorcontrib>Gatti, Marco</creatorcontrib><creatorcontrib>Faletti, Riccardo</creatorcontrib><creatorcontrib>Colinet, Valentin</creatorcontrib><creatorcontrib>Lefebvre, Yolene</creatorcontrib><creatorcontrib>Bodard, Sylvain</creatorcontrib><creatorcontrib>Diamand, Romain</creatorcontrib><creatorcontrib>Fiard, Gaelle</creatorcontrib><title>Role of the Prostate Imaging Quality PI-QUAL Score for Prostate Magnetic Resonance Image Quality in Pathological Upstaging After Radical Prostatectomy: A Multicentre European Study</title><title>European urology open science (Online)</title><addtitle>Eur Urol Open Sci</addtitle><description><![CDATA[PI-QUAL (Prostate Imaging Quality) is a new score used to standardize the assessment of multiparametric magnetic resonance imaging (mpMRI). We provide further evidence that PI-QUAL has clinical implications. mpMRI of insufficient quality, defined as PI-QUAL <3, results in a higher rate of pathological upstaging. Increasing use of multiparametric magnetic resonance imaging (mpMRI) has come with heterogeneity in image quality. The Prostate Imaging Quality (PI-QUAL) score is under scrutiny to assess its usefulness in predicting clinical outcomes. To compare upstaging of localized disease on mpMRI (mrT2) to locally invasive disease in radical prostatectomy (RP) specimens (≥pT3a) in relation to PI-QUAL. Patients treated with RP between 2015 and 2020 who underwent 1.5–3-T mpMRI within 6 mo before surgery and had systematic and mpMRI-US targeted biopsies were included. mpMRI scans were retrospectively assigned a PI-QUAL score, and prospectively acquired Prostate Imaging-Recording and Data System (PI-RADS) scores (version 2.0 or 2.1) were used. PI-QUAL scores were categorized as nondiagnostic (PI-QUAL <3), sufficient (PI-QUAL 3), or optimal (PI-QUAL >3). We assessed the relationship between the PI-QUAL score and upstaging using multivariate logistic regression. mpMRI, clinical, and pathological findings were compared using χ2 tests and analysis of variance. We identified 351 patients, of whom 40 (11.4%) had PI-QUAL <3, 57 (16.3%) had PI-QUAL 3, and 254 (72.3%) had PI-QUAL >3 scores. The distribution of PI-QUAL <3 (0–33.6%; p < 0.001) and PI-QUAL >3 (37.3–100%; p < 0.001) scores varied widely among centers. PI-QUAL ≥3 in comparison to PI-QUAL <3 was associated with a lower rate of upstaging (19% vs 35%; p = 0.02), greater detection of mrT3a and mrT3b prostate cancer (17.0% vs 2.5%; p = 0.016), a higher rate of PI-RADS 5 lesions (47% vs 27.5%; p = 0.002), a higher number of suspicious lesion (PI-RADS ≥3: 34.7% vs 15%; p = 0.012), and higher detection rates for aggregated (50.7% vs 22.5%; p = 0.001) and late (21.2% vs 0%; p < 0.001) extraprostatic extension. On multivariate analysis, PI-QUAL<3 was associated with more frequent upstaging in the RP specimen (odds ratio 3.4; p = 0.01). In comparison to PI-QUAL ≥3, PI-QUAL <3 was significantly associated with a higher rate of upstaging from organ-confined disease on mpMRI to locally advanced disease on pathology, lower detection rates for PI-RADS 5 lesions and extraprostatic extension, and a lower number of suspicious lesions. Poor image quality for magnetic resonance imaging (MRI) scans of the prostate is associated with underestimation of the stage of prostate cancer.]]></description><subject>Prostate Cancer</subject><issn>2666-1683</issn><issn>2666-1691</issn><issn>2666-1683</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kdFu0zAUhiMEYtPYEyAhX3KTYDuN4yCBVE0bVOpE19Fry7GPU1dpXGxnUt-LB8RrtzJuuLLl8___OT5flr0nuCCYsE-bAkbvQkExpQUhBSblq-ycMsZywnj5-sX9LLsMYYMxphUhrKZvs7OSMUzwhJ9nv5euB-QMimtAi5QYZQQ028rODh26G2Vv4x4tZvndajpH98p5QMb5v9Jb2Q0QrUJLCG6Qgzq64eS1A1rIuHa966ySPVrtkvGQPjURPFpKfXh_TlTRbfef0RTdjn3KhSGmltfpszuQA7qPo96_y94Y2Qe4fDovstXN9c-r7_n8x7fZ1XSeq4pWMa8J4ZTrGpey4VXJpJk0DcEVhxJz2tK61VKrytCKEwLA25aayaSptDatbgwpL7Kvx9zd2G5BH2aRvdh5u5V-L5y04t_KYNeicw-i4ZjVmKeAj08B3v0aIUSxtUFB38sB3BgErVmaMYHASVoepSrtIXgwpzYEi0fkYiMOyMUjckGISMiT68PLCU-eZ8BJ8OUogLSnBwteBGUhUdLWp1UL7ex_G_wBIrDB1w</recordid><startdate>20230101</startdate><enddate>20230101</enddate><creator>Windisch, Olivier</creator><creator>Benamran, Daniel</creator><creator>Dariane, Charles</creator><creator>Favre, Martina Martins</creator><creator>Djouhri, Mehdi</creator><creator>Chevalier, Maxime</creator><creator>Guillaume, Bénédicte</creator><creator>Oderda, Marco</creator><creator>Gatti, Marco</creator><creator>Faletti, Riccardo</creator><creator>Colinet, Valentin</creator><creator>Lefebvre, Yolene</creator><creator>Bodard, Sylvain</creator><creator>Diamand, Romain</creator><creator>Fiard, Gaelle</creator><general>Elsevier B.V</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20230101</creationdate><title>Role of the Prostate Imaging Quality PI-QUAL Score for Prostate Magnetic Resonance Image Quality in Pathological Upstaging After Radical Prostatectomy: A Multicentre European Study</title><author>Windisch, Olivier ; Benamran, Daniel ; Dariane, Charles ; Favre, Martina Martins ; Djouhri, Mehdi ; Chevalier, Maxime ; Guillaume, Bénédicte ; Oderda, Marco ; Gatti, Marco ; Faletti, Riccardo ; Colinet, Valentin ; Lefebvre, Yolene ; Bodard, Sylvain ; Diamand, Romain ; Fiard, Gaelle</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c525t-711828d703a98536af4991058e3082b27bdadc5f25811ee8bb2f4495ddfbd9f13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Prostate Cancer</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Windisch, Olivier</creatorcontrib><creatorcontrib>Benamran, Daniel</creatorcontrib><creatorcontrib>Dariane, Charles</creatorcontrib><creatorcontrib>Favre, Martina Martins</creatorcontrib><creatorcontrib>Djouhri, Mehdi</creatorcontrib><creatorcontrib>Chevalier, Maxime</creatorcontrib><creatorcontrib>Guillaume, Bénédicte</creatorcontrib><creatorcontrib>Oderda, Marco</creatorcontrib><creatorcontrib>Gatti, Marco</creatorcontrib><creatorcontrib>Faletti, Riccardo</creatorcontrib><creatorcontrib>Colinet, Valentin</creatorcontrib><creatorcontrib>Lefebvre, Yolene</creatorcontrib><creatorcontrib>Bodard, Sylvain</creatorcontrib><creatorcontrib>Diamand, Romain</creatorcontrib><creatorcontrib>Fiard, Gaelle</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European urology open science (Online)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Windisch, Olivier</au><au>Benamran, Daniel</au><au>Dariane, Charles</au><au>Favre, Martina Martins</au><au>Djouhri, Mehdi</au><au>Chevalier, Maxime</au><au>Guillaume, Bénédicte</au><au>Oderda, Marco</au><au>Gatti, Marco</au><au>Faletti, Riccardo</au><au>Colinet, Valentin</au><au>Lefebvre, Yolene</au><au>Bodard, Sylvain</au><au>Diamand, Romain</au><au>Fiard, Gaelle</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Role of the Prostate Imaging Quality PI-QUAL Score for Prostate Magnetic Resonance Image Quality in Pathological Upstaging After Radical Prostatectomy: A Multicentre European Study</atitle><jtitle>European urology open science (Online)</jtitle><addtitle>Eur Urol Open Sci</addtitle><date>2023-01-01</date><risdate>2023</risdate><volume>47</volume><spage>94</spage><epage>101</epage><pages>94-101</pages><issn>2666-1683</issn><issn>2666-1691</issn><eissn>2666-1683</eissn><abstract><![CDATA[PI-QUAL (Prostate Imaging Quality) is a new score used to standardize the assessment of multiparametric magnetic resonance imaging (mpMRI). We provide further evidence that PI-QUAL has clinical implications. mpMRI of insufficient quality, defined as PI-QUAL <3, results in a higher rate of pathological upstaging. Increasing use of multiparametric magnetic resonance imaging (mpMRI) has come with heterogeneity in image quality. The Prostate Imaging Quality (PI-QUAL) score is under scrutiny to assess its usefulness in predicting clinical outcomes. To compare upstaging of localized disease on mpMRI (mrT2) to locally invasive disease in radical prostatectomy (RP) specimens (≥pT3a) in relation to PI-QUAL. Patients treated with RP between 2015 and 2020 who underwent 1.5–3-T mpMRI within 6 mo before surgery and had systematic and mpMRI-US targeted biopsies were included. mpMRI scans were retrospectively assigned a PI-QUAL score, and prospectively acquired Prostate Imaging-Recording and Data System (PI-RADS) scores (version 2.0 or 2.1) were used. PI-QUAL scores were categorized as nondiagnostic (PI-QUAL <3), sufficient (PI-QUAL 3), or optimal (PI-QUAL >3). We assessed the relationship between the PI-QUAL score and upstaging using multivariate logistic regression. mpMRI, clinical, and pathological findings were compared using χ2 tests and analysis of variance. We identified 351 patients, of whom 40 (11.4%) had PI-QUAL <3, 57 (16.3%) had PI-QUAL 3, and 254 (72.3%) had PI-QUAL >3 scores. The distribution of PI-QUAL <3 (0–33.6%; p < 0.001) and PI-QUAL >3 (37.3–100%; p < 0.001) scores varied widely among centers. PI-QUAL ≥3 in comparison to PI-QUAL <3 was associated with a lower rate of upstaging (19% vs 35%; p = 0.02), greater detection of mrT3a and mrT3b prostate cancer (17.0% vs 2.5%; p = 0.016), a higher rate of PI-RADS 5 lesions (47% vs 27.5%; p = 0.002), a higher number of suspicious lesion (PI-RADS ≥3: 34.7% vs 15%; p = 0.012), and higher detection rates for aggregated (50.7% vs 22.5%; p = 0.001) and late (21.2% vs 0%; p < 0.001) extraprostatic extension. On multivariate analysis, PI-QUAL<3 was associated with more frequent upstaging in the RP specimen (odds ratio 3.4; p = 0.01). In comparison to PI-QUAL ≥3, PI-QUAL <3 was significantly associated with a higher rate of upstaging from organ-confined disease on mpMRI to locally advanced disease on pathology, lower detection rates for PI-RADS 5 lesions and extraprostatic extension, and a lower number of suspicious lesions. Poor image quality for magnetic resonance imaging (MRI) scans of the prostate is associated with underestimation of the stage of prostate cancer.]]></abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>36601048</pmid><doi>10.1016/j.euros.2022.11.013</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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subjects	Prostate Cancer
title	Role of the Prostate Imaging Quality PI-QUAL Score for Prostate Magnetic Resonance Image Quality in Pathological Upstaging After Radical Prostatectomy: A Multicentre European Study
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