We aimed to systematically assess the inter-reader agreement of the Prostate Imaging Reporting and Data System Version (PI-RADS) v2.1 for the detection of prostate cancer (PCa).

We included studies reporting inter-reader agreement of different radiologists that applied PI-RADS v2.1 for the detection of PCa. Quality assessment of the included studies was performed with the Guidelines for Reporting Reliability and Agreement Studies. The summary estimates of the inter-reader agreement were pooled with the random-effect model and categorized (from slight to almost perfect) according to the kappa (κ) value. Multiple subgroup analyses and meta-regression were performed to explore various clinical settings.

A total of 12 studies comprising 2475 patients were included. The pooled inter-reader agreement for whole gland was κ=0.65 (95% CI 0.56-0.73), and for transitional zone (TZ) lesions was κ=0.62 (95% CI 0.51-0.72). There was substantial heterogeneity presented throughout the studies (I²= 95.6%), and meta-regression analyses revealed that only readers’ experience (<5 years vs. ≥5 years) was the significant factor associated with heterogeneity (P<0.01). In studies providing head-to-head comparison, there was no significant difference in inter-reader agreement between PI-RADS v2.1 and v2.0 for both the whole gland (0.64 vs. 0.57, p=0.37), and TZ (0.61 vs. 0.59, p=0.81).

PI-RADS v2.1 demonstrated substantial inter-reader agreement among radiologists for whole gland and TZ lesions. However, the difference in agreement between PI-RADS v2.0 and v2.1 was not significant for the whole gland or the TZ.

我们旨在系统地评估前列腺成像报告和数据系统版本 (PI-RADS) v2.1 用于检测前列腺癌 (PCa) 的读者间协议。

我们纳入的研究报告了应用 PI-RADS v2.1 检测 PCa 的不同放射科医生的读者间协议。纳入研究的质量评估是根据报告可靠性和一致性研究指南进行的。读者间一致性的汇总估计与随机效应模型合并，并根据 kappa (从轻微到几乎完美) 进行分类 (κ） 价值。进行了多个亚组分析和元回归以探索各种临床环境。

共纳入 12 项研究，包括 2475 名患者。整个腺体的汇总读者间协议是κ= 0.65 (95% CI 0.56-0.73)，对于过渡区 (TZ) 病变为κ= 0.62 (95% CI 0.51-0.72)。在整个研究中存在显着的异质性（我² = 95.6%），元回归分析显示，只有读者的经验（<5 年 vs. ≥5 年）是与异质性相关的重要因素（P<0.01）。在提供头对头比较的研究中，PI-RADS v2.1 和 v2.0 对整个腺体的读者间一致性没有显着差异（0.64 对 0.57，p= 0.37）和 TZ（0.61 对 0.59，p=0.81)。

PI-RADS v2.1 显示放射科医师对整个腺体和 TZ 病变的读者间有实质性的一致性。然而，PI-RADS v2.0 和 v2.1 之间的一致性差异对于整个腺体或 TZ 并不显着。