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Prostate Imaging Reporting and Data System (PI-RADS): What the radiologists need to know?
Ahmed Abdel Khalek Abdel Razek1, Tarek El-Diasty2, Ahmed Elhendy2
1Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt.
Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1) updates Multiparametric MRI (MpMRI) protocols and interpretation guidelines. Simplified PI-RADS and Biparametric MRI (BpMRI) are increasingly used for clinically significant prostate cancer detection.
Area of Science:
- Radiology
- Medical Imaging
- Urology
Background:
- Prostate cancer diagnosis relies heavily on imaging.
- The Prostate Imaging Reporting and Data System (PI-RADS) standardizes MRI interpretation.
- Version 2.1 (PI-RADS v2.1) introduces significant updates to the previous version.
Purpose of the Study:
- To review modifications in MR imaging technique, interpretation, lexicon, and scoring within PI-RADS v2.1.
- To provide a practical overview of the latest PI-RADS guidelines.
- To highlight the growing role of Biparametric MRI (BpMRI) in prostate cancer assessment.
Main Methods:
- Review of technical modifications in Multiparametric MRI (MpMRI) protocols.
- Analysis of updated image interpretation guidelines for specific prostate zones.
- Examination of scoring system clarifications for diffusion-weighted imaging (DWI) and dynamic contrast enhancement (DCE).
Main Results:
- PI-RADS v2.1 details new technical aspects of T2, DWI, and DCE sequences.
- Updated guidelines address interpretation in challenging locations like the central zone and anterior fibromuscular stroma.
- Clarifications are provided for T2 scoring in the transition zone and DWI/DCE distinctions.
Conclusions:
- PI-RADS v2.1 offers refined guidelines for prostate MRI interpretation.
- Biparametric MRI (BpMRI) combined with simplified PI-RADS is emerging as a valuable tool.
- These advancements aim to improve the detection of clinically significant prostate cancer.
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