Multi-reader Evaluation of the Prostate Imaging Quality Score System Version 2 (PI-QUAL V2) and its Clinical Application

Motivation: PI-QUAL V2 was released in May 2024, but its application in clinical practice remains unclear. Goal(s): To investigate the inter-reader consistency of PI-QUAL V2 and its impact on radiologists' diagnostic confidence and diagnostic performance for csPCa. Approach: Three radiologists with varying levels of expertise independently assigned PI-QUAL V2 scores to prostate MRI of 581 patients. Inter-observer agreement was evaluated by Kappa statistics. AUC-ROC was employed to evaluate the diagnostic performance for csPCa under various scores. Results: This study validated its positive role in inter-reader reproducibility and radiologists' MRI diagnosis. However, the value of PI-QUAL V2 in the overall diagnosis of csPCa is limited. Impact: Undoubtedly, the introduction of PI-QUAL V2 serves as the cornerstone for the widespread application of MRI in prostate clinical practice. However, to constitute an optimal quality assessment framework, it may still require adaptation and fine-tuning.