title: Prostate imaging reporting and data system version 2 (PI-RADS v2): a pictorial review.
abstract: The most recent edition of the prostate imaging reporting and data system (PI-RADS version 2) was developed based on expert consensus of the international working group on prostate cancer. It provides the minimum acceptable technical standards for MR image acquisition and suggests a structured method for multiparametric prostate MRI (mpMRI) reporting. T1-weighted, T2-weighted (T2W), diffusion-weighted (DWI), and dynamic contrast-enhanced (DCE) imaging are the suggested sequences to include in mpMRI. The PI-RADS version 2 scoring system enables the reader to assess and rate all focal lesions detected at mpMRI to determine the likelihood of a clinically significant cancer. According to PI-RADS v2, a lesion with a Gleason score ≥7, volume >0.5 cc, or extraprostatic extension is considered clinically significant. PI-RADS v2 uses the concept of a dominant MR sequence based on zonal location of the lesion rather than summing each component score, as was the case in version 1. The dominant sequence in the peripheral zone is DWI and the corresponding apparent diffusion coefficient (ADC) map, with a secondary role for DCE in equivocal cases (PI-RADS score 3). For lesions in the transition zone, T2W images are the dominant sequence with DWI/ADC images playing a supporting role in the case of an equivocal lesion.
authors: Department of Radiology, Surgical Planning Lab, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, ASB1-L1-Room 050, Boston, MA, 02115, USA. elmitt@gmail.com.
authors: Elmira
authors: 0000-0003-4460-698X
authors: E
authors: Hassanzadeh
authors: Department of Radiology, Surgical Planning Lab, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, ASB1-L1-Room 050, Boston, MA, 02115, USA.
authors: Daniel I
authors: DI
authors: Glazer
authors: Department of Radiology, Surgical Planning Lab, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, ASB1-L1-Room 050, Boston, MA, 02115, USA.
authors: Ruth M
authors: RM
authors: Dunne
authors: Department of Radiology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
authors: Fiona M
authors: FM
authors: Fennessy
authors: Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.
authors: Mukesh G
authors: MG
authors: Harisinghani
authors: Department of Radiology, Surgical Planning Lab, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, ASB1-L1-Room 050, Boston, MA, 02115, USA.
authors: Clare M
authors: CM
authors: Tempany
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D060787:Neoplasm Grading; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D011873:Radiology Information Systems
chemical_list: D003287:Contrast Media