Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

An online national quality assessment survey of prostate MRI reading : interreader variability in prostate volume measurement and PI-RADS classification

Wallström, Jonas ; Thimansson, Erik LU ; Andersson, Jim ; Karlsson, Mathias ; Zackrisson, Sophia LU ; Bratt, Ola LU and Jäderling, Fredrik (2025) In European Journal of Radiology Open 14.
Abstract

Background: High-quality assessment of prostate MRI is fundamental in both clinical practice and screening. There is a lack of national level data on variability in prostate volume measurement and PI-RADS assessment. Methods of quality assurance need to be developed. Methods: All Swedish radiology departments were invited to participate in an external quality assurance of prostate MRI reading. Ten prostate MRI cases were selected by an expert panel to reflect common findings. Readers measured whole gland volume (ellipsoid formula method) and assigned a PI-RADS score in a web-based PACS with full clinical functionality. Expert consensus was used as reference standard. Descriptive statistics were used to show the distribution of volume... (More)

Background: High-quality assessment of prostate MRI is fundamental in both clinical practice and screening. There is a lack of national level data on variability in prostate volume measurement and PI-RADS assessment. Methods of quality assurance need to be developed. Methods: All Swedish radiology departments were invited to participate in an external quality assurance of prostate MRI reading. Ten prostate MRI cases were selected by an expert panel to reflect common findings. Readers measured whole gland volume (ellipsoid formula method) and assigned a PI-RADS score in a web-based PACS with full clinical functionality. Expert consensus was used as reference standard. Descriptive statistics were used to show the distribution of volume measurements and PSA density. Reader agreement was assessed using percentages and kappa scores. A feedback document was sent to all participants upon completion of the quality assurance program. Results: Forty-three radiologists representing 17 departments read at least 7 out of 10 cases. The median difference in prostate volume assessment compared to the reference volume for the 10 cases ranged from −23 mL to + 6 mL. Per case agreement ranged from 33 % to 86 % for the assigned PI-RADS score and from 35 % to 98 % for PI-RADS 1–3 versus PI-RADS 4–5. Interreader agreement was moderate with a median kappa score of 0.53 (IQR 0.48–0.62). Conclusion: This online model for national quality assurance programs was feasible. Rather large per-case reader variations in prostate volume assessment and PI-RADS scoring were shown. To reduce variability in clinical practice, systematic interreader comparisons should be encouraged.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Magnetic resonance imaging, Observer Variation, Prostatic Neoplasms, Radiology, Training
in
European Journal of Radiology Open
volume
14
article number
100625
publisher
Elsevier
external identifiers
  • pmid:39758711
  • scopus:85211965953
ISSN
2352-0477
DOI
10.1016/j.ejro.2024.100625
language
English
LU publication?
yes
id
74335b7c-a44a-4854-8ed8-3346cf53cf6f
date added to LUP
2025-02-26 15:06:58
date last changed
2025-07-03 02:09:58
@article{74335b7c-a44a-4854-8ed8-3346cf53cf6f,
  abstract     = {{<p>Background: High-quality assessment of prostate MRI is fundamental in both clinical practice and screening. There is a lack of national level data on variability in prostate volume measurement and PI-RADS assessment. Methods of quality assurance need to be developed. Methods: All Swedish radiology departments were invited to participate in an external quality assurance of prostate MRI reading. Ten prostate MRI cases were selected by an expert panel to reflect common findings. Readers measured whole gland volume (ellipsoid formula method) and assigned a PI-RADS score in a web-based PACS with full clinical functionality. Expert consensus was used as reference standard. Descriptive statistics were used to show the distribution of volume measurements and PSA density. Reader agreement was assessed using percentages and kappa scores. A feedback document was sent to all participants upon completion of the quality assurance program. Results: Forty-three radiologists representing 17 departments read at least 7 out of 10 cases. The median difference in prostate volume assessment compared to the reference volume for the 10 cases ranged from −23 mL to + 6 mL. Per case agreement ranged from 33 % to 86 % for the assigned PI-RADS score and from 35 % to 98 % for PI-RADS 1–3 versus PI-RADS 4–5. Interreader agreement was moderate with a median kappa score of 0.53 (IQR 0.48–0.62). Conclusion: This online model for national quality assurance programs was feasible. Rather large per-case reader variations in prostate volume assessment and PI-RADS scoring were shown. To reduce variability in clinical practice, systematic interreader comparisons should be encouraged.</p>}},
  author       = {{Wallström, Jonas and Thimansson, Erik and Andersson, Jim and Karlsson, Mathias and Zackrisson, Sophia and Bratt, Ola and Jäderling, Fredrik}},
  issn         = {{2352-0477}},
  keywords     = {{Magnetic resonance imaging; Observer Variation; Prostatic Neoplasms; Radiology; Training}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{European Journal of Radiology Open}},
  title        = {{An online national quality assessment survey of prostate MRI reading : interreader variability in prostate volume measurement and PI-RADS classification}},
  url          = {{http://dx.doi.org/10.1016/j.ejro.2024.100625}},
  doi          = {{10.1016/j.ejro.2024.100625}},
  volume       = {{14}},
  year         = {{2025}},
}