• MRI Prostate - Prof. Dr. Villeirs

 

• PI-RADS

 

PI-RADS 1: very low (clinically significant cancer is highly unlikely to be present)

PI-RADS 2: low (clinically significant cancer is unlikely to be present)

PI-RADS 3: intermediate (the presence of clinically significant cancer is equivocal)

PI-RADS 4: high (clinically significant cancer is likely to be present)

PI-RADS 5: very high (clinically significant cancer is highly likely to be present)

 

T2-weighted imaging

 

Peripheral zone (PZ)

1: uniform high signal intensity (SI)

2: linear or wedge shaped hypointensity or diffuse mild hypointensity, usually indistinct margin

3: heterogeneous signal intensity or non-circumscribed, rounded, moderate hypointensity; includes others that do not qualify as 2, 4, or 5

4: circumscribed, homogenous moderately hypointense focus or mass confined to prostate and <1.5cm in the greatest dimension

5: same as 4 but ≥1.5 cm in greatest dimension or definite extraprostatic extension/invasive behavior

 

Transition zone (TZ)

1: homogenous intermediate signal intensity

2: circumscribed hypointense or heterogeneous encapsulated nodule(s) (BPH)

3: heterogeneous signal intensity with obscured margins. Includes others that do no qualify as 2, 4, or 5

4: lenticular or non-circumscribed, homogenous moderately hypointense, and <1.5cm in greatest dimension

5: same as 4, but ≥1.5cm in greatest dimension or definite extraprostatic extension/invasive behavior

 

Diffusion weighted imaging (DWI)

1: no abnormality and ADC and high b-value DWI

2: indistinct hypointense on ADC

3: focal mildly/moderately hypointense on ADC and isointense/mildly hyperintense on high b-value DWI

4: focal markedly hypointense on ADC hyperintense on high b-value DWI; <1.5cm in greatest dimension

5: same as 4 but ≥1.5cm in greatest dimension or definite extraprostatic extension/invasive behavior