IP1-PROSTAGRAM研究凸显了短双参数“Prostagram”磁共振成像（bpMRI）扫描在前列腺癌筛查中的潜力。我们旨在比较PI-RADSv2和Likert量表在IP1-PROSTAGRAM范围内对于检测临床重要和不重要的前列腺癌的活检建议率和准确性。50-69岁的男性接受Prostagram MRI筛查。扫描结果由专业泌尿外科放射医师使用PI-RADSv2（除去动态增强序列评分）和5分Likert评分进行前瞻性报告。如果得分≥3，无论哪种评分系统，均推荐行系统性和靶向经阴道前列腺活检。比较了推荐活检的患者比例和1级及≥2级等级组的检出率。进行了接受者操作特征（ROC）分析以比较性能。共有406名男性接受Prostagram MRI。中位年龄和PSA分别为57岁（IQR 53-61）和0.91 ng/mL（0.56-1.74）。MRI得分≥3时，根据Likert标准更多患者被推荐进行活检（94/406，23% [95% CI 19.2-27.6%]），相比之下，根据PI-RADSv2标准只有（72/406，18% [14.2-21.9%]；p=0.03）。对于得分≥4的情况，PI-RADSv2和Likert评分导致43/406名（11%，7.9%-14.1%）和35/406名（9%，6.2-11.9%）男性被推荐进行活检（p=0.40）。对于GG≥2的检出，PI-RADSv2和Likert标准分别检出22%（11.4-30.8%，72/406）和16%（9.5-25.3%，94/406）的男性（p=0.56）。对于GG1级癌症的检出率分别为11%（4.3-19.6%，7/72）和11%（4.7-17.8%，9/94）（p=1.00）。PI-RADS和Likert量表的准确性相似（AUROC 0.64 vs 0.65，p=0.95）。在筛查人群中报告无对比剂Prostagram MRI时，PI-RADSv2和Likert量表的准确性相当；然而，使用Likert量表会导致更多男性接受活检，而不会增加重要癌症的检出率。为了改善对Prostagram MRI的报告，应开发PI-RADS或修改后的Likert量表或独立的评分系统。本文受版权保护。保留所有权利。

The IP1-PROSTAGRAM study highlighted the potential of short biparametric "Prostagram" magnetic resonance imaging (bpMRI) scanning in screening for prostate cancer. We aimed to compare biopsy recommendation rates and accuracy of PI-RADSv2 with the Likert scale for detection of clinically significant and insignificant prostate cancer in men screened within IP1-PROSTAGRAM.Men aged 50-69 years were screened with Prostagram MRI. Scans were prospectively reported using both PI-RADSv2 (excluding dynamic contrast-enhanced sequence score) and 5-point Likert scores by expert uro-radiologists. Systematic and targeted transperineal biopsy was recommended if the scan was scored ≥3, based on either reporting system. The proportion of patients recommended for biopsy and detection rates for grade groups (GG) 1 and ≥2 were compared. Receiver operating characteristic (ROC) analysis was performed to compare performance.406 men underwent Prostagram MRI. Median age and PSA were 57 years (IQR 53-61) and 0.91 ng/mL (0.56-1.74), respectively. At MRI score ≥3, more patients were recommended for biopsy based on Likert criteria (94/406, 23% [95% CI 19.2-27.6%]) compared to PI-RADSv2 (72/406, 18% [14.2-21.9%]; p=0.03). For scores ≥4, PI-RADSv2 and Likert scales led to 43/406 (11%, 7.9%-14.1%) and 35/406 (9%, 6.2-11.9%) men recommended for biopsy (p=0.40). For GG≥2 detection, PIRADSv2 and Likert detected 22% (11.4-30.8%, 14/72) and 16% (9.5-25.3%, 15/94), respectively (p=0.56). For GG1 cancers detection these were 11% (4.3-19.6%, 7/72) vs 11% (4.7-17.8%, 9/94) (p=1.00). The accuracy of PI-RADS and Likert scale was similar (AUROC 0.64 vs 0.65, p=0.95).In reporting non-contrast-enhanced Prostagram MRI in a screening population, the PI-RADSv2 and Likert scoring systems were equally accurate; however, Likert scale use led to a more men undergoing biopsy without a subsequent increase in significant cancer detection rates. To improve reporting of Prostagram MRI, either the PI-RADS or a modified Likert scale or a standalone scoring system should be developed.This article is protected by copyright. All rights reserved.