Das Prostatakarzinom: Validierung der Interrater- und Intrarater-Reliabilität von PSMA-RADS 1.0 zur strukturierten Befundung in der hybriden Bildgebung

Blom, Franziska Nora (2025): Das Prostatakarzinom: Validierung der Interrater- und Intrarater-Reliabilität von PSMA-RADS 1.0 zur strukturierten Befundung in der hybriden Bildgebung. Dissertation, LMU München: Medizinische Fakultät

Abstract

Introduction: PSMA-RADS Version 1.0 is a structured reporting and data sys- tem (RADS) for evaluating prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) in patients with prostate cancer (PCa). Prostate cancer is the most common malignant tumor in men in Germany. Accurate diagnosis and staging are crucial in clinical practice. Struc- tured reporting enables a systematic and uniform classification of results and is increasingly applied in clinical practice. As part of this dissertation, the intra- and interreader agreement of PSMA-RADS 1.0 was evaluated for four readers with varying experience levels. The study aimed to assess the potential benefit of in- tegrating this system into clinical practice. Materials and Methods PSMA PET/CT scans of 103 patients were inde- pendently evaluated by four raters with varying experience levels according to the PSMA-RADS 1.0 criteria at two time points. A waiting period of at least four weeks was maintained between evaluations. A maximum of five target lesions were freely selected per scan and classified according to the PSMA-RADS 1.0 criteria. Both the overall scan score and compartment-based scores were as- sessed. Intra- and interrater agreement were statistically analyzed using intra- class correlation coefficients (ICC). Part of the data has already been published in the study “Grawe F, Blom F, Winkelmann M, Burgard C, Schmid-Tannwald C, Unterrainer LM, Sheikh GT, Pfitzinger PL, Kazmierczak P, Cyran CC, Ricke J, Stief CG, Bartenstein P, Ruebenthaler J, Fabritius MP, Geyer T. Reliability and practicability of PSMA-RADS 1.0 for structured reporting of PSMA PET/CT scans in prostate cancer patients. Eur Radiol. 2024 Feb;34(2):1157-1166. doi: 10.1007/s00330-023-10083-7. Epub 2023 Aug 25. PMID: 37624414; PMCID: PMC10853294”. Results PSMA-RADS 1.0 showed excellent interreader agreement across all four readers for the assessment of overall scans (ICC ≥ 91%) as well as com- partment-based scores (ICC ≥ 93%). The intrareader agreement was also excel- lent, regardless of the readers level of experience, both for the assessment of overall scan scores (ICC ≥ 86%) and for individual compartments (ICC ≥ 95%). Conclusion PSMA-RADS 1.0 shows to be a reliable system for the standardized evaluation of PSMA PET/CT scans. The high level of agreement among reader shows the system's potential to provide a unified approach to diagnosis and treat- ment planning for patients with prostate cancer. The excellent intrareader agree- ment further ensures the reliability and reproducibility of the reporting results. PSMA-RADS 1.0 can also confidently be used by less experienced readers. The structured reporting and data system are a valuable addition to clinical practice.

• Dokumententyp: Dissertationen (Dissertation, LMU München)
• Keywords: PSMA-RADS 1.0, Prostatakarzinom, Interraterreliabilität, Intraraterreliabilität
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften ; 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Fakultäten: Medizinische Fakultät
• Sprache der Hochschulschrift: Deutsch
• Datum der mündlichen Prüfung: 23. Oktober 2025
• 1. Bericht­erstatter:in: Rübenthaler, Johannes