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[Prostate Imaging Reporting and Data System (PI-RADS) v 2.1: Overview and Critical Points].

Chan Kyo Kim

    Journal of the Korean Society of Radiology
    |February 23, 2023
    PubMed
    Summary

    The Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1) updates multiparametric MRI criteria for prostate cancer evaluation. While improved, this review highlights remaining challenges and new issues needing further research and clarification.

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    Area of Science:

    • Radiology
    • Oncology
    • Medical Imaging

    Context:

    • The Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) provides standardized criteria for prostate cancer detection using multiparametric MRI (mpMRI).
    • PI-RADS v2.1 represents an update to these guidelines, aiming to refine prostate cancer evaluation.
    • Despite updates, certain aspects of PI-RADS v2.1 require further investigation and clarification.

    Purpose:

    • To provide an overview of the updated PI-RADS v2.1 guidelines.
    • To critically discuss the strengths and limitations of PI-RADS v2.1 in prostate cancer assessment.
    • To identify areas requiring further research and protocol refinement.

    Summary:

    • PI-RADS v2.1 updates technical parameters and interpretation criteria for mpMRI in prostate cancer evaluation.
    • Key discussion points include the need for detailed mpMRI protocols, validation of transition zone criteria, and clarification of diffusion-weighted and dynamic contrast-enhanced imaging criteria.
    • Further considerations involve anterior fibromuscular stroma and central zone assessment, background signal, tumor aggressiveness, structured reporting changes, quality control parameters, and expanded indications.

    Impact:

    • This review aims to guide clinicians and researchers in the optimal application of PI-RADS v2.1.
    • Addressing the identified issues can lead to more accurate and reliable prostate cancer detection and characterization.
    • Further research and standardization will enhance the utility of mpMRI in prostate cancer management.