Multicenter analysis for inter reader agreement of PIQUAL score v2 for basic readers in prostate MRI

Orman M., ŞİROLU S., Seker M. E., ALİS D. C., Kartal M. S., Basar Y., ...More

Scientific Reports, vol.15, no.1, 2025 (SCI-Expanded, Scopus) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 15 Issue: 1
  • Publication Date: 2025
  • Doi Number: 10.1038/s41598-025-02973-1
  • Journal Name: Scientific Reports
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, Chemical Abstracts Core, MEDLINE, Veterinary Science Database, Directory of Open Access Journals
  • Keywords: Image quality, MRI, PI-QUAL, Prostate, Prostate Cancer
  • Acibadem Mehmet Ali Aydinlar University Affiliated: Yes

Abstract

The Prostate Imaging Quality (PI-QUAL) V2 is a simplified update of PI-QUAL V1 for assessing image quality in multiparametric prostate MRI (mpMRI), aimed at improving clinical use and reproducibility. This study evaluated inter-reader agreement of PI-QUAL V2 among basic prostate readers using multicenter mpMRI data and compared it to PI-QUAL V1. Five readers assessed T2-weighted, DWI (including ADC maps), and DCE images from 274 men (median age: 71 years, IQR: 60–78) across five centers. Inter-reader agreement was measured using weighted Gwet’s AC1 coefficients and compared using bootstrapped confidence intervals. For PI-QUAL V1, coefficients ranged from 0.659 to 0.855, indicating substantial-to-almost perfect agreement. For PI-QUAL V2, coefficients ranged from 0.821 to 0.897, showing almost perfect agreement. All 10 pairwise comparisons achieved almost perfect agreement for PI-QUAL V2, compared to only 3 of 10 for V1. Additionally, three comparisons showed non-overlapping confidence intervals, indicating statistically significant improvements with V2. PI-QUAL V2 demonstrated consistently higher inter-reader agreement than V1, with basic prostate readers achieving almost perfect agreement across multicenter mpMRI data. These findings highlight the improved reliability and clinical applicability of PI-QUAL V2.