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Table 1 PI-RADS version 2 interpretation rules for mpMRI to detect csPCa

From: Evolution of prostate MRI: from multiparametric standard to less-is-better and different-is better strategies

Peripheral zone PI-RADS category Transition zone
Finding appearance on DWI DCE   DWI Finding appearance on T2WI
Score 1: no abnormalities on ADC and high b value DWI 1 Score 1: Uniform hyperintense signal intensity
Score 2: indistinct hypointensity on ADC 2 Score 2: Linear or wedge-shaped hypointensity or diffuse mild hypointensity
Score 3: focal hypointensity on ADC and isointensity on high b value DWI No focal and early enhancement 3 If DWI score ≤ 4 Score 3: Heterogeneous signal intensity or non-circumscribed, rounded, moderate hypointensity
Focal and early enhancement 4 If DWI score = 5
Score 4: focal markedly hypointensity on ADC and markedly hyperintensity on high b value DWI 4 Score 4: Circumscribed, homogenous moderate hypointense focus/mass confined to prostate, and < 1.5 cm in greatest dimension
Score 5: same as 4 but ≥ 1.5 cm in greatest dimension or definite extraprostatic extension/invasive behaviour 5 Score 5: Same as 4 but ≥ 1.5 cm in greatest dimension or definite extraprostatic extension/invasive behaviour
  1. csPCa Clinical significant prostate cancer, DCE dynamic contrast-enhanced imaging, DWI diffusion-weighted imaging, PI-RADS Prostate Imaging Reporting and Data System, T2WI T2-weighted imaging. Probability of csPCa: category 1 = very low, category 2 = low, category 3 = intermediate/equivocal, category 4 = high, category 4 = very high