Multiparametric MRI Approach to Prostate Cancer with a Pictorial Essay on PI-RADS

• Main Authors: Palak B. Popat, Sharad Maheshwari, Nilesh P. Sable, Meenakshi Thakur, Aparna Katdare
• Format: Article
• Language: English
• Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2019-06-01
• Series: Journal of Gastrointestinal and Abdominal Radiology
• Subjects: multiparametric magnetic resonance imaging; pi-rads; prostate cancer
• Online Access: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1683454

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.