{"id":2299,"date":"2017-11-29T19:07:50","date_gmt":"2017-11-29T19:07:50","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/radpi-rads\/"},"modified":"2026-02-27T21:09:34","modified_gmt":"2026-02-27T21:09:34","slug":"radpi-rads","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/radpi-rads\/","title":{"rendered":"Prostate Imaging Reporting And Data System (PI-RADS)"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>PI-RADS is designed to improve focal lesion detection, localization, characterization, and risk stratification in patients with suspected cancer and consists of technical recommendation for MRI acquisition and a scoring system for image interpretation. PI-RADS uses a scale of 1\u20135 to report the overall probability of clinically significant prostate cancer on multiparametric MRI (mpMRI). The use of PI-RADS is limited to treatment naive patients and it should not be used for staging, assessment of treatment outcome, recurrence, or progression during surveillance.<br \/>\n<!--more--><\/p>\n<p><strong>Prostate imaging reporting and data system (PI-RADS)<\/strong><br \/>\nThe score is assessed on prostate MRI. Images are obtained using a multiparametric technique including T2 weighted images, a dynamic contrast study (DCE), and diffusion-weighted magnetic resonance imaging (DWI).<br \/>\nA score is given according to each variable. The scale is based on a score from 1 to 5 (which is given for each lesion), with 1 being most probably benign and 5 being highly suspicious of malignancy.<br \/>\n<strong>Overall PI-RADS score definition<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td style=\"border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt;\" valign=\"top\">\n<p class=\"MsoNormal\"><b><span lang=\"ES-AR\">\u00a0<\/span>PI-RADS<\/b><\/p>\n<\/td>\n<td style=\"border: solid windowtext 1.0pt; border-left: none; mso-border-left-alt: solid windowtext .5pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt;\" valign=\"top\">\n<p class=\"MsoNormal\"><b><span lang=\"ES-AR\">\u00a0<\/span>Definition<\/b><\/p>\n<\/td>\n<td style=\"border: solid windowtext 1.0pt; border-left: none; mso-border-left-alt: solid windowtext .5pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt;\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"text-align: center;\"><b>Overall score with\u00a0T2,<br \/>\nDWI, and DCE<\/b><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"border: solid windowtext 1.0pt; border-top: none; mso-border-top-alt: solid windowtext .5pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt;\" valign=\"top\">\n<p class=\"MsoNormal\"><span lang=\"ES-AR\">\u00a01<\/span><\/p>\n<\/td>\n<td style=\"border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; mso-border-top-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt;\" valign=\"top\">\n<p class=\"MsoNormal\"><span lang=\"ES-AR\">\u00a0<\/span>Most probably benign<\/p>\n<\/td>\n<td style=\"border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; mso-border-top-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt;\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"text-align: center;\"><span lang=\"ES-AR\">\u00a03-4<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"border: solid windowtext 1.0pt; border-top: none; mso-border-top-alt: solid windowtext .5pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt;\" valign=\"top\">\n<p class=\"MsoNormal\"><span lang=\"ES-AR\">\u00a02<\/span><\/p>\n<\/td>\n<td style=\"border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; mso-border-top-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt;\" valign=\"top\">\n<p class=\"MsoNormal\"><span lang=\"ES-AR\">\u00a0<\/span>Probably benign<\/p>\n<\/td>\n<td style=\"border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; mso-border-top-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt;\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"text-align: center;\"><span lang=\"ES-AR\">\u00a05-6<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"border: solid windowtext 1.0pt; border-top: none; mso-border-top-alt: solid windowtext .5pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt;\" valign=\"top\">\n<p class=\"MsoNormal\"><span lang=\"ES-AR\">\u00a03<\/span><\/p>\n<\/td>\n<td style=\"border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; mso-border-top-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt;\" valign=\"top\">\n<p class=\"MsoNormal\"><span lang=\"ES-AR\">\u00a0<\/span>Indeterminate<\/p>\n<\/td>\n<td style=\"border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; mso-border-top-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt;\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"text-align: center;\"><span lang=\"ES-AR\">\u00a07-9<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"border: solid windowtext 1.0pt; border-top: none; mso-border-top-alt: solid windowtext .5pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt;\" valign=\"top\">\n<p class=\"MsoNormal\"><span lang=\"ES-AR\">\u00a04<\/span><\/p>\n<\/td>\n<td style=\"border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; mso-border-top-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt;\" valign=\"top\">\n<p class=\"MsoNormal\"><span lang=\"ES-AR\">\u00a0<\/span>Probably malignant<\/p>\n<\/td>\n<td style=\"border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; mso-border-top-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt;\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"text-align: center;\"><span lang=\"ES-AR\">\u00a010-12<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"border: solid windowtext 1.0pt; border-top: none; mso-border-top-alt: solid windowtext .5pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt;\" valign=\"top\">\n<p class=\"MsoNormal\"><span lang=\"ES-AR\">\u00a05<\/span><\/p>\n<\/td>\n<td style=\"border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; mso-border-top-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt;\" valign=\"top\">\n<p class=\"MsoNormal\"><span lang=\"ES-AR\">\u00a0<\/span>Highly suspicious for malignancy<\/p>\n<\/td>\n<td style=\"border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; mso-border-top-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt;\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"text-align: center;\"><span lang=\"ES-AR\">\u00a013-15<\/span><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><b>The revised PI-RADS<\/b><br \/>\nT2-WI for PZ<\/p>\n<ol>\n<li>Uniform signal hyperintensity (normal)<\/li>\n<li>Linear, wedge?shaped, or diffuse mild hypointensity, usually indistinct margin<\/li>\n<li>Heterogeneous signal intensity or noncircumscribed, rounded, moderate hypointensity<\/li>\n<li>Circumscribed, homogeneously moderate hypointense focus or mass confined to prostate and &lt;1.5 cm in greatest dimension<\/li>\n<li>Same as 4 but &gt;\/=1.5 cm in greatest dimension or definite extraprostatic extension or invasive behavior<\/li>\n<\/ol>\n<p>T2-WI for TZ<\/p>\n<ol>\n<li>Homogeneously intermediate signal intensity (normal)<\/li>\n<li>Circumscribed hypointense or heterogeneous encapsulated nodule(s) (BPH)<\/li>\n<li>Heterogeneous signal intensity with obscured margins. Includes others that do not qualify as 2, 4, or 5<\/li>\n<li>Lenticular or noncircumscribed, homogeneous, moderately hypointense and &lt;1.5 cm in greatest dimension<\/li>\n<li>Same as 4, but\u00a0&gt;\/= 1.5 cm in greatest dimension or definite extraprostatic extension or invasive behavior<\/li>\n<\/ol>\n<p>DWI<\/p>\n<ol>\n<li>No abnormality on ADC and DWI with high b-value (<span style=\"font-size: 12.16px;\">&gt;\/=<\/span>1400)<\/li>\n<li>Indistinct hypointense on ADC maps<\/li>\n<li>Focal mildly or moderately hypointense on ADC maps and isointense or mildly hyperintense on high b-value DWI (<span style=\"font-size: 12.16px;\">&gt;\/=<\/span>1400)<\/li>\n<li>Focal markedly hypointense on ADC maps and markedly hyperintense on DWI with high b values (&gt;\/=1400) and &lt;1.5 cm on axial images<\/li>\n<li>Same as 4 but\u00a0<span style=\"font-size: 12.16px;\">&gt;\/=<\/span>1.5 cm in greatest dimension or definite extraprostatic extension and invasive behavior<\/li>\n<\/ol>\n<p>DCE<\/p>\n<ul>\n<li>Negative: No early enhancement, diffuse enhancement not corresponding to a focal finding on T2-WI and\/or DWI, or focal enhancement corresponding to a lesion showing features of BPH on T2-WI<\/li>\n<li>Positive: Focal enhancement and enhancement earlier than or contemporaneously with that of adjacent normal prostatic tissues and findings corresponding with findings suspicious for cancer on T2-WI and\/or DWI images<\/li>\n<\/ul>\n<p>DCE is used to decide between PIRADS 3 (no focal or early enhancement) or upgrade to PIRADS 4 (focal and early enhancement present).<\/p>\n<p>DCE: Dynamic contrast-enhanced; MRI: Magnetic resonance imaging; PZ: Peripheral zone; TZ: Transition zone; SI: Signal intensity;\u00a0DWI: Diffusion-weighted imaging; ADC: Apparent diffusion coefficient;\u00a0T2-WI: T2-weighted imaging; T1-WI: T1-weighted imaging; BPH: Benign\u00a0prostatic hyperplasia; PI-RADS: Prostate Imaging Reporting and Data System<\/p>\n<p>&nbsp;<\/p>\n<p><strong>References:<\/strong><\/p>\n<ol>\n<li>Barrett T, Turkbey B, Choyke PL. PI-RADS version 2: what you need to know.\u00a0Clin Radiol. 2015 Nov;70(11):1165-76. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/26231470\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Zhang L, Tang M, Chen S, Lei X, Zhang X, Huan Y.\u00a0A meta-analysis of use of Prostate Imaging Reporting and Data System Version 2 (PI-RADS V2) with multiparametric MR imaging for the detection of prostate cancer.\u00a0Eur Radiol. 2017 Dec;27(12):5204-5214.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/28656462\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Hassanzadeh E, Glazer DI, Dunne RM, Fennessy FM, Harisinghani MG, Tempany CM. Prostate imaging reporting and data system version 2 (PI-RADS v2): a pictorial review. Abdom Radiol (NY). 2017 Jan;42(1):278-289. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27522352\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Agrotis G, Pooch EP, Marsitopoulos K, Vlychou M, Benndorf M, Beets-Tan RGH, Schoots IG. Detection rates for prostate cancer using PI-RADS 2.1 upgrading rules in transition zone lesions align with risk assessment categories: a systematic review and meta-analysis. Eur Radiol. 2025 Oct;35(10):6454-6465. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40287872\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created Nov 29, 2017.<br \/>\nUp-date Feb 27, 2026.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[508],"tags":[322,506,520,500,519,518,517,516,515,497,495,514,450,507],"class_list":["post-2299","post","type-post","status-publish","format-standard","hentry","category-radiology","tag-cancer","tag-data","tag-imagenes","tag-imaging","tag-mri","tag-pi","tag-pi-rads","tag-prostata","tag-prostate","tag-rads","tag-reporting","tag-rnm","tag-score","tag-system"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2299","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2299"}],"version-history":[{"count":4,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2299\/revisions"}],"predecessor-version":[{"id":10677,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2299\/revisions\/10677"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2299"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2299"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2299"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}