ArticleWorld journal of urology2025
Impact of the PI-QUAL MRI quality score on histopathological up-staging from MRI fusion biopsy to final prostatectomy specimen.
Article in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Impact of MRI quality on the accuracy of targeted prostate biopsy: A prospective PI-QUAL analysis.European journal of radiology · 2026Article
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10 authors.
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Abstract
purposeThe qualitative heterogeneity of multiparametric MRI (mpMRI) poses significant challenges for the diagnostic pathway of prostate cancer (PCa). The Prostate Imaging Quality Score (PI-QUAL) is a novel tool for the qualitative assessment of mpMRI. Aim of this study was to evaluate the impact of PI-QUAL on consistency of radiological to pathological T-stage.
methodsPatients undergoing MRI-TRUS fusion biopsy and radical prostatectomy (RP) from 01/2016 to 03/2024 were retrospectively included. PI-QUAL was determined by two expert radiologists and categorised: inadequate (1-2), sufficient (3) and optimal (4-5). Primary endpoint was upstaging from locally confined disease in mpMRI (mrT ≤ 2) to advanced in RP-specimen (pT ≥ 3a). Variables were compared using analysis of variance and χ
resultsOf 349 patients included, 18 had PI-QUAL 1-2, 44 PI-QUAL 3 and 287 PI-QUAL 4-5. Patient characteristics, PI-RADS scores and biopsy counts were balanced between these groups. Upstaging from mrT ≤ 2 to pT ≥ 3a was significantly more frequent in PI-QUAL 1-2 (22.4%) and PI-QUAL 3 (22.7%) compared to PI-QUAL 4-5 (10.8%) (p = 0.031). Suboptimal mpMRI harbours an increased risk of upstaging (HR 2.22; 95% CI 1.05-4.71; p = 0.037). Optimal mpMRI quality independently predicts higher PI-RADS grading (PI-RADS ≥ 4) (HR 2.27; 95% CI 1.02-5.00; p = 0.043).
conclusionPI-QUAL (≤ 3) significantly influences PI-RADS grading and predicts for upstaging from radiological to pathological staging. In case of suboptimal image quality, repetition of mpMRI should be considered.
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