Prostate MRI based on PI-RADS version 2: how we review and report

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Prostate cancer diagnosis relies on multiparametric magnetic resonance imaging (mpMRI).
• Standardized interpretation guidelines are crucial for accurate prostate cancer assessment.
• Current guidelines, PI-RADS™ v2, aim for global standardization in prostate mpMRI.

Purpose of the Study:

• To provide clinical guidelines for prostate mpMRI using PI-RADS™ v2.
• To promote standardization in acquisition, interpretation, and reporting of prostate mpMRI.
• To improve detection, localization, and risk stratification of clinically significant prostate cancer in treatment-naïve glands.

Main Methods:

• Utilizes a 5-point PI-RADS™ category scale (1-5) based on mpMRI findings.
• Integrates T2-weighted (T2w), diffusion-weighted MRI (DWI), and dynamic contrast-enhanced MRI (DCE-MRI) sequences.
• DWI is dominant for peripheral zone, T2w for transition zone; DCE-MRI plays a minor role.

Main Results:

• PI-RADS™ v2 standardizes communication between radiologists and urologists.
• The system enhances the likelihood of detecting or excluding significant prostate cancer.
• Findings are categorized to indicate the probability of clinically significant cancer.

Conclusions:

• PI-RADS™ v2 offers a standardized framework for prostate mpMRI interpretation.
• The guidelines improve the consistency and accuracy of prostate cancer diagnosis.
• This system aids in identifying significant prostate cancer in patients requiring initial treatment decisions.