PI-RADS 2.1 and structured reporting of magnetic resonance imaging of the prostate

Abstract

Clinical/methodological issue: The detection of clinically significant prostate cancers while simultaneously avoiding over-diagnosing tumors with low malignant potential is a challenge in clinical practice. Standard radiological methods: Multiparametric prostate magnetic resonance imaging (MRI) in accordance with the Prostate Imaging Reporting and Data System (PI-RADS) guidelines is accepted as standard-of-care with both urologists and radiologists. Methodological innovations: The PI-RADS guidelines have been updated to version 2.1, including revised technical recommendations and changes to the scoring of lesions. Performance: The PI-RADS guidelines have had great impact on the standardization of multiparametric prostate MRI and offer templates for structured reporting. This simplifies communication with the referring physician. Achievements: The new version 2.1 of the guidelines represents an evolutionary improvement of the widely accepted version 2.0. Several aspects of reporting have been revised—however, some pre-known limitations persist, which will require further refinement in the future.