scholarly journals Understanding PI-QUAL for prostate MRI quality: a practical primer for radiologists

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Francesco Giganti ◽  
Alex Kirkham ◽  
Veeru Kasivisvanathan ◽  
Marianthi-Vasiliki Papoutsaki ◽  
Shonit Punwani ◽  
...  
Keyword(s):  
Diffusion Weighted Imaging ◽  
Signal To Noise Ratio ◽  
High Signal ◽  
Diagnostic Quality ◽  
Prostate Mri ◽  
Prostate Imaging ◽  
Dynamic Contrast Enhanced ◽  
Diffusion Weighted ◽  
Contrast Enhanced

AbstractProstate magnetic resonance imaging (MRI) of high diagnostic quality is a key determinant for either detection or exclusion of prostate cancer. Adequate high spatial resolution on T2-weighted imaging, good diffusion-weighted imaging and dynamic contrast-enhanced sequences of high signal-to-noise ratio are the prerequisite for a high-quality MRI study of the prostate. The Prostate Imaging Quality (PI-QUAL) score was created to assess the diagnostic quality of a scan against a set of objective criteria as per Prostate Imaging-Reporting and Data System recommendations, together with criteria obtained from the image. The PI-QUAL score is a 1-to-5 scale where a score of 1 indicates that all MR sequences (T2-weighted imaging, diffusion-weighted imaging and dynamic contrast-enhanced sequences) are below the minimum standard of diagnostic quality, a score of 3 means that the scan is of sufficient diagnostic quality, and a score of 5 implies that all three sequences are of optimal diagnostic quality. The purpose of this educational review is to provide a practical guide to assess the quality of prostate MRI using PI-QUAL and to familiarise the radiologist and all those involved in prostate MRI with this scoring system. A variety of images are also presented to demonstrate the difference between suboptimal and good prostate MR scans.

scholarly journals Inter-reader agreement of the PI-QUAL score for prostate MRI quality in the NeuroSAFE PROOF trial

2021 ◽  
Author(s):  
Francesco Giganti ◽  
Eoin Dinneen ◽  
Veeru Kasivisvanathan ◽  
Aiman Haider ◽  
Alex Freeman ◽  
...  
Keyword(s):  
Confidence Intervals ◽  
Diffusion Weighted Imaging ◽  
Interobserver Agreement ◽  
Weighted Kappa ◽  
Diagnostic Quality ◽  
Prostate Imaging ◽  
Dynamic Contrast Enhanced ◽  
Percent Agreement ◽  
Contrast Enhanced

Abstract Objectives The Prostate Imaging Quality (PI-QUAL) score assesses the quality of multiparametric MRI (mpMRI). A score of 1 means all sequences are below the minimum standard of diagnostic quality, 3 implies that the scan is of sufficient diagnostic quality, and 5 means that all three sequences are of optimal diagnostic quality. We investigated the inter-reader reproducibility of the PI-QUAL score in patients enrolled in the NeuroSAFE PROOF trial. Methods We analysed the scans of 103 patients on different MR systems and vendors from 12 different hospitals. Two dedicated radiologists highly experienced in prostate mpMRI independently assessed the PI-QUAL score for each scan. Interobserver agreement was assessed using Cohen’s kappa with standard quadratic weighting (κw) and percent agreement. Results The agreement for each single PI-QUAL score was strong (κw = 0.85 and percent agreement = 84%). A similar agreement (κw = 0.82 and percent agreement = 84%) was observed when the scans were clustered into three groups (PI-QUAL 1–2 vs PI-QUAL 3 vs PI-QUAL 4–5). The agreement in terms of diagnostic quality for each single sequence was highest for T2-weighted imaging (92/103 scans; 89%), followed by dynamic contrast-enhanced sequences (91/103; 88%) and diffusion-weighted imaging (80/103; 78%). Conclusion We observed strong reproducibility in the assessment of PI-QUAL between two radiologists with high expertise in prostate mpMRI. At present, PI-QUAL offers clinicians the only available tool for evaluating and reporting the quality of prostate mpMRI in a systematic manner but further refinements of this scoring system are warranted. Key Points • Inter-reader agreement for each single Prostate Imaging Quality (PI-QUAL) score (i.e., PI-QUAL 1 to PI-QUAL 5) was strong, with weighted kappa = 0.85 (95% confidence intervals: 0.51 – 1) and percent agreement = 84%. • Interobserver agreement was strong when the scans were clustered into three groups according to the ability (or not) to rule in and to rule out clinically significant prostate cancer (i.e., PI-QUAL 1-2 vs PI-QUAL 3 vs PI-QUAL 4–5), with weighted kappa = 0.82 (95% confidence intervals: 0.68 – 0.96) and percent agreement = 84%. • T2-weighted acquisitions were the most compliant with the Prostate Imaging Reporting and Data System (PI-RADS) v. 2.0 technical recommendations and were the sequences of highest diagnostic quality for both readers in 95/103 (92%) scans, followed by dynamic contrast enhanced acquisition with 81/103 (79%) scans and lastly by diffusion-weighted imaging with 79/103 (77%) scans.

Multiparametric Approach with Dynamic Contrast-Enhanced Mri, Diffusion-Weighted Imaging and Mrs of The Breast in Assessment of Suspicious Breast Lesions

2020 ◽  
Vol 106 (1_suppl) ◽  
pp. 16-16
Author(s):  
SM Abd Elsalam ◽  
AH Said ◽  
MH Sarah
Keyword(s):  
Magnetic Resonance ◽  
Diffusion Weighted Imaging ◽  
Kinetic Curve ◽  
Resonance Spectroscopy ◽  
Breast Lesions ◽  
Adc Value ◽  
Dynamic Contrast Enhanced ◽  
Cancer Breast ◽  
Diffusion Weighted ◽  
Contrast Enhanced

Introduction: Breast cancer is the most invasive malignant tumour in females worldwide and is the second leading cause of cancer death in females after lung cancer. In Egypt, cancer breast is the first common site of tumours among females (32%) and the second common tumour site in both sexes. The aim of this study was to evaluate and compare the diagnostic performance of quantitative parameters derived from diffusion-weighted imaging (DWI), dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and magnetic resonance spectroscopy (MRS) with ultrasound +/- conventional mammography in differentiating suspicious breast masses (BI-RADS III and IV) and to suggest the most accurate imaging combination for early diagnosis and treatment of cancer breast. Materials and Methods: The study included 40 patients with suspicious breast lesions detected by clinical examination, ultrasound+/- mammography . Dynamic MRI study was performed using 1.5T MRI. Lesions were analyzed regarding their morphology, kinetic curve pattern, ADC value and tCho peak measurement. The results of each MRI parameter were correlated to histo-pathology. Results: In this study sensitivity of sono-mammography was 70% and its specificity was 66.6%. According to using MRI sensitivity was 90% and specificity was 80% by using morphological and curve patterns. As regarding MRS sensitivity was 50% and specificity was 86.7%. Regarding sensitivity of ADC was 90%while its specificity was 93%. The cut off ADC value was 0.95 x 10−3 mm2/s. By using MRI with additive modalities (ADC and MRS) sensitivity was 100% and specificity was 93%. Conclusion: In comparison with MRI, sonomammography alone lack both sensitivity and specificity in detection of breast lesions in suspicious cases. MRI with additive modalities (ADC and MRS) is the best imaging modality in detection of malignant cases and exclusion of benign cases.

scholarly journals Dynamic Contrast-Enhanced Perfusion MRI and Diffusion-Weighted Imaging in Grading of Gliomas

2015 ◽  
Vol 25 (5) ◽  
pp. 792-798 ◽  
Author(s):  
Julio Arevalo-Perez ◽  
Kyung K. Peck ◽  
Robert J. Young ◽  
Andrei I. Holodny ◽  
Sasan Karimi ◽  
...  
Keyword(s):  
Diffusion Weighted Imaging ◽  
Perfusion Mri ◽  
Dynamic Contrast Enhanced ◽  
Diffusion Weighted ◽  
Contrast Enhanced ◽  
And Diffusion
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