Prostate Imaging Reporting and Data System (PI-RADS): What the radiologists need to know?

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Ahmed Abdel Khalek Abdel Razek1, Tarek El-Diasty2, Ahmed Elhendy2

  • 1Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt.

Clinical Imaging
|June 7, 2021
PubMed

Insights

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.
Keywords:
MR imagingProstate Imaging Reporting and Data SystemProstate cancer

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