Abstract
In current practice, multiparametric prostate magnetic resonance imaging (mpMRI) plays a crucial role in the initial assessment of men who have a clinical suspicion of prostate cancer, in biopsy decision-making by categorizing the likelihood of clinically significant prostate cancer, and in guiding biopsy procedures. The Prostate Imaging-Reporting and Data System version 2.1 (PI-RADS v2.1) is a standardized system that guides the acquisition techniques of mpMRI, as well as the interpretation and reporting of mpMRI in the diagnosis of prostate cancer. This chapter will review the current version of PI-RADS, along with its performance, pitfalls, and limitations.
Keywords: Prostate cancer, multiparametric prostate MRI, PI-RADS v2.1
References
Bergengren O, Pekala KR, Matsoukas K, Fainberg J, Mungovan SF, Bratt O, et al. 2022 update on prostate cancer epidemiology and risk factors-a systematic review.Eur Urol.2023; 84: 191-206.
Turkbey B, Rosenkrantz AB, Haider MA, Padhani AR, Villeirs G, Macura KJ, et al. Prostate Imaging Reporting and Data System Version 2.1: 2019 update of prostate imaging reporting and data system version 2.Eur Urol.2019; 76: 340-51.
Barentsz JO, Richenberg J, Clements R, Choyke P, Verma S, Villeirs G, et al. ESUR prostate MR guidelines 2012.Eur Radiol.2012; 22: 746-57.
Weinreb JC, Barentsz JO, Choyke PL, Cornud F, Haider MA, Macura KJ, et al. PI-RADS prostate imaging - reporting and data system: 2015, version 2.Eur Urol.2016; 69: 16-40.
Purysko AS, Baroni RH, Giganti F, Costa D, Renard-Penna R, Kim CK, et al. PI-RADS version 2.1: a critical review, from theAJR special series on radiology reporting and data systems. AJR Am J Roentgenol.2021; 216: 20-32.
Caglic I, Hansen NL, Slough RA, Patterson AJ, Barrett T. Evaluating the effect of rectal distension on prostate multiparametric MRI image quality.Eur J Radiol2017; 90: 174-80.
Park KJ, Choi SH, Kim MH, Kim JK, Jeong IG. Performance of prostate imaging reporting and data system version 2.1 for diagnosis of prostate cancer: a systematic review and meta-analysis.J Magn Reson Imaging.2021; 54: 103-12.
Lee CH, Vellayappan B, Tan CH. Comparison of diagnostic performance and inter-reader agreement between PI-RADS v2.1 and PI-RADS v2: systematic review and meta-analysis.Br J Radiol. 2022; 95: 20210509.
Oerther B, Engel H, Bamberg F, Sigle A, Gratzke C, Benndorf M. Cancer detection rates of the PI-RADSv2.1 assessment categories: systematic review and meta-analysis on lesion level and patient level.Prostate Cancer Prostatic Dis.2022; 25: 256-63.
Kasivisvanathan V, Rannikko AS, Borghi M, Panebianco V, Mynderse LA, Vaarala MH, et al. MRI-targeted or standard biopsy for prostate-cancer diagnosis.N Engl J Med.2018; 378: 1767-77.
Johnson DC, Raman SS, Mirak SA, Kwan L, Bajgiran AM, Hsu W, et al RE. Detection of individual prostate cancer foci via multiparametric magnetic resonance imaging.Eur Urol.2019; 75: 712-20.
Shakur A, Hames K, O’Shea A, Harisinghani MG. Prostatitis: imaging appearances and diagnostic considerations.Clin Radiol.2021; 76: 416-26.
Gold SA, Hale GR, Bloom JB, Smith CP, Rayn KN, Valera V, et al. Follow-up of negative MRI-targeted prostate biopsies: when are we missing cancer?World J Urol. ; 37: 235-41.
Annamalai A, Fustok JN, Beltran-Perez J, Rashad AT, Krane LS, Triche BL. Interobserver agreement and accuracy in interpreting mpMRI of the prostate: a systematic review.Curr Urol Rep.2022; 23: 1-10.
Turkbey B, Purysko AS. PI-RADS: where next?Radiology.2023; 307: e223128.
Gaur S, Harmon S, Rosenblum L, Greer MD, Mehralivand S, Coskun M, et al. Can apparent diffusion coefficient values assist PI-RADS version 2 DWI scoring? A correlation study using the PI-RADSv2 and International Society of Urological Pathology Systems.AJR Am J Roentgenol.2018; 211: W33-W41.
Tavakoli AA, Hielscher T, Badura P, Görtz M, Kuder TA, Gnirs R, et al. Contribution of dynamic contrast-enhanced and diffusion MRI to PI-RADS for detecting clinically significant prostate cancer.Radiology.2023; 306: 186-99.
Alver KH, Yagci AB, Utebey AR, Turk NS, Ufuk F. Comparison of multiparametric and fast MRI protocols in detecting clinically significant prostate cancer and a detailed cost analysis.J Magn Reson Imaging.2022; 56: 1437-47.
Coşkun M, Sarp AF, Karasu Ş, Gelal MF, Türkbey B. Assessment of the compliance with minimum acceptable technical parameters proposed by PI-RADS v2 guidelines in multiparametric prostate MRI acquisition in tertiary referral hospitals in the Republic of Turkey.Diagn Interv Radiol.2019; 25: 421-7.
Karanasios E, Caglic I, Zawaideh JP, Barrett T. Prostate MRI quality: clinical impact of the PI-QUAL score in prostate cancer diagnostic work-up.Br J Radiol.2022; 95: 20211372.


