RadEssentialReading-room reference
PI-RADS v2.1
Dominant sequence: DWI for peripheral zone, T2W for transition zone. DCE only upgrades PZ score 3 to 4. Size cutoff for 4 vs 5 is 1.5 cm.
PZ · DWI score
| Score | Finding |
|---|---|
| 1 | Normal on ADC and high b-value |
| 2 | Linear or wedge-shaped hypointense on ADC and/or hyperintense on high b |
| 3 | Focal, mildly/moderately hypointense on ADC and/or iso/mildly hyperintense on high b; may be markedly abnormal on one but not both |
| 4 | Focal markedly hypointense on ADC and markedly hyperintense on high b; <1.5 cm |
| 5 | As 4 but ≥1.5 cm, or definite extraprostatic extension/invasive behavior |
TZ · T2W score
| Score | Finding |
|---|---|
| 1 | Normal TZ, or round completely encapsulated nodule (typical nodule) |
| 2 | Mostly encapsulated nodule, or homogeneous circumscribed nodule without encapsulation (atypical nodule), or homogeneous mildly hypointense area between nodules |
| 3 | Heterogeneous signal with obscured margins; anything not fitting 2, 4 or 5 |
| 4 | Lenticular or non-circumscribed, homogeneous, moderately hypointense; <1.5 cm |
| 5 | As 4 but ≥1.5 cm, or definite extraprostatic extension/invasive behavior |
Overall category
PI-RADS–
PZ: DWI 3 + DCE positive → 4. TZ: T2W 2 + DWI ≥4 → 3; T2W 3 + DWI 5 → 4. DCE positive = focal early enhancement corresponding to a T2W/DWI finding.
Sources
- Turkbey B, Rosenkrantz AB, Haider MA, et al. Prostate Imaging Reporting and Data System version 2.1: 2019 update of Prostate Imaging Reporting and Data System version 2. Eur Urol. 2019;76:340–351.PubMed ↗
Radessential summarizes published classification systems for practicing radiologists. Summaries are condensed; confirm details against the cited source before relying on them for patient care.