| Summary: | The biology of prostate cancer is indolent, and incidence does not reflect mortality. This has led to reframed screening guidelines pivoting around serum prostate-specific antigen (PSA) and conceptualizing clinically significant prostate cancer (CSC), triaging active surveillance and intervention. A resultant paradigm shift in magnetic resonance imaging (MRI) from diagnosing cancer to focusing on detecting CSC led to the establishment of PI-RADS v2 (prostate imaging reporting and data systems, version 2). In this article, we present an approach to analyzing suspicious prostate lesions on multiparametric MRI (mp-MRI) and assigning them a PI-RADS assessment score based on the current version 2 for standardized reporting, strengthening diagnostic accuracy, and improving clinical acceptance. We also present pitfalls and challenges that a radiologist should be aware of, for increasing diagnostic accuracy.
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