Validation of the MRI prostate imaging for recurrence reporting assessment score - PI - RR

Abstract

Background: The increase in prostate-specific antigen (PSA) levels among patients who underwent treatment for localized prostate cancer (PCa) varies from 27-53%, with the variability depending on the tumor stage or type of treatment (radical prostatectomy or radiotherapy). The use of multiparametric magnetic resonance imaging (mpMRI) to evaluate patients with biochemical recurrences (BCR) is a disputed topic. In 2021, genitourinary radiology experts established the Prostate Imaging for Recurrence Reporting (PI-RR) System, a clinical practice guideline designed to standardize mpMRI acquisition, interpretation, and reporting for patients. The guideline's primary aim is to improve the assessment of patients with recurrent PCa by enhancing diagnostic performance and personalizing treatment. Objective: The primary aim of this study is to evaluate the efficacy of the PI-RR scoring system in precisely detecting localized prostate cancer via mpMRI in patients with biochemical recurrence and who have undergone radical prostatectomy or radiotherapy. Design and Methods: This is a bicentric, retrospective, and descriptive study that aims to collect images of patients with BCR who underwent mpMRI, covering the period from September 12, 2013, to November 14, 2023. The images will be interpreted by four radiologists with varying levels of expertise through the utilization of the PI-RR system. The PI-RR score from the reports will be classified as either positive or negative. A PI-RR score of 3 or higher will be considered positive, while a score less than 3 will be negative. The results will then be compared with standard references to compute sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and likelihood ratio