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Updated: Nov 27, 2025
A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
Published on: March 21, 2025
Prostate MRI: practical guidelines for interpreting and reporting according to PI-RADS version 2.1
R Sánchez-Oro1, J Torres Nuez1, G Martínez-Sanz1
1Servicio de Radiodiagnóstico, Hospital General de Teruel Obispo Polanco, Teruel, España.
Abstract:
The increasing precision of multiparametric magnetic resonance imaging of the prostate, together with greater experience and standardization in its interpretation, has given this technique an important role in the management of prostate cancer, the most prevalent non-cutaneous cancer in men. This article reviews the concepts in PI-RADS version 2.1 for estimating the probability and zonal location of significant tumors of the prostate, using a practical approach that includes current considerations about the prerequisites for carrying out the test and recommendations for interpreting the findings. It emphasizes benign findings that can lead to confusion and the criteria for evaluating the probability of local spread, which must be included in the structured report.
Insights
Multiparametric MRI (mpMRI) with PI-RADS 2.1 improves prostate cancer detection. This review details its interpretation for accurate diagnosis and management of significant prostate tumors.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Prostate cancer is the most common non-cutaneous cancer in men.
- Multiparametric MRI (mpMRI) has become crucial in prostate cancer management.
- Increasing precision and standardization enhance mpMRI's role.
Purpose of the Study:
- To review PI-RADS version 2.1 concepts for prostate cancer assessment.
- To provide practical guidance on mpMRI interpretation.
- To highlight common pitfalls and local spread evaluation.
Main Methods:
- Review of PI-RADS v2.1 guidelines.
- Practical approach to interpreting prostate mpMRI.
- Emphasis on prerequisites and findings interpretation.
- Criteria for assessing local spread probability.
Main Results:
- PI-RADS 2.1 standardizes the estimation of significant prostate tumor probability and location.
- Identifies benign findings that may mimic malignancy.
- Provides criteria for evaluating local spread potential.
- Highlights the importance of structured reporting.
Conclusions:
- Standardized mpMRI interpretation using PI-RADS 2.1 is essential for accurate prostate cancer management.
- Understanding potential diagnostic challenges improves clinical decision-making.
- Structured reporting of mpMRI findings facilitates optimal patient care.
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