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Use of MRI-ultrasound Fusion to Achieve Targeted Prostate Biopsy
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Published on: April 9, 2019

PI-RADS v2.1 for prostate MRI: current applications, ongoing debates, and synergies with advanced technologies-a

Siying Zhang1, Xiaoli Wang1, Mingyang Guo1

  • 1Department of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Translational Andrology and Urology
|June 15, 2026
PubMed
Abstract

Insights

Prostate Imaging Reporting and Data System (PI-RADS) version 2.1 enhances prostate MRI consistency for cancer detection. Integrating PI-RADS with biomarkers and AI shows promise for personalized diagnostics, though further validation is needed.

Area of Science:

  • Radiology
  • Oncology
  • Medical Imaging

Background:

  • Prostate Imaging Reporting and Data System (PI-RADS) version 2.1 is the standard for prostate multiparametric MRI (mpMRI).
  • It aims to improve diagnostic consistency for clinically significant prostate cancer (csPCa).

Purpose of the Study:

  • To summarize PI-RADS v2.1 applications and diagnostic performance.
  • To analyze its limitations and explore synergies with biomarkers, biparametric MRI (bpMRI), AI, and quantitative MRI.

Main Methods:

  • Comprehensive literature search of PubMed and Web of Science up to December 2025.
  • Inclusion of original research and systematic reviews on PI-RADS v2.1 and prostate MRI innovations.

Main Results:

  • PI-RADS v2.1 refines criteria but faces challenges in variability and patient preparation.
  • Integration with PSA density improves risk stratification for PI-RADS 3 lesions.
  • bpMRI, AI (deep learning, radiomics), and advanced quantitative MRI techniques offer complementary diagnostic value.

Conclusions:

  • PI-RADS v2.1 advances prostate MRI standardization but has limitations.
  • Combining PI-RADS with biomarkers and emerging technologies enables more precise, personalized diagnosis.
  • Prospective studies are required to validate these integrated approaches.
Keywords:
Prostate Imaging Reporting and Data System v2.1 (PI-RADS v2.1)Prostate cancer (PCa)artificial intelligence (AI)biparametric magnetic resonance imaging (bpMRI)multiparametric magnetic resonance imaging (mpMRI)

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