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Evaluation of the ESUR PI-RADS scoring system for multiparametric MRI of the prostate with targeted MR/TRUS fusion-guided biopsy at 3.0 Tesla

An Erratum to this article was published on 07 February 2014



To evaluate the Prostate Imaging Reporting and Data System (PI-RADS) proposed by the European Society of Urogenital Radiology (ESUR) for detection of prostate cancer (PCa) by multiparametric magnetic resonance imaging (mpMRI) in a consecutive cohort of patients with magnetic resonance/transrectal ultrasound (MR/TRUS) fusion-guided biopsy.


Suspicious lesions on mpMRI at 3.0 T were scored according to the PI-RADS system before MR/TRUS fusion-guided biopsy and correlated to histopathology results. Statistical correlation was obtained by a Mann–Whitney U test. Receiver operating characteristics (ROC) and optimal thresholds were calculated.


In 64 patients, 128/445 positive biopsy cores were obtained out of 95 suspicious regions of interest (ROIs). PCa was present in 27/64 (42 %) of the patients. ROC results for the aggregated PI-RADS scores exhibited higher areas under the curve compared to those of the Likert score. Sensitivity/specificity for the following thresholds were calculated: 73 %/92 % and 85 %/67 % for PI-RADS scores of 9 and 10, respectively; 85 %/56 % and 60 %/97 % for Likert scores of 3 and 4, respectively.


The standardised ESUR PI-RADS system is beneficial to indicate the likelihood of PCa of suspicious lesions on mpMRI. It is also valuable to identify locations to be targeted with biopsy. The aggregated PI-RADS score achieved better results compared to the single five-point Likert score.

Key points

The ESUR PI-RADS scoring system was evaluated using multiparametric 3.0-T MRI.

To investigate suspicious findings, transperineal MR/TRUS fusion-guided biopsy was used.

PI-RADS can guide biopsy locations and improve detection of clinically significant cancer.

Biopsy procedures can be optimised, reducing unnecessary negative biopsies for patients.

The PI-RADS scoring system may contribute to more effective prostate MRI.

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apparent diffusion coefficient


Breast Imaging Reporting and Data System


confidence interval


dynamic contrast enhanced


Digital Imaging and Communication in Medicine


digital rectal examination


diffusion-weighted imaging


European Society of Urogenital Radiology


half-Fourier acquisition turbo spin echo


magnetic resonance imaging


magnetic resonance spectroscopy


prostate cancer


Prostate Imaging Reporting and Data System


prostate specific antigen


receiver operating characteristic






transrectal ultrasound


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Correspondence to M. C. Roethke.

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Roethke, M.C., Kuru, T.H., Schultze, S. et al. Evaluation of the ESUR PI-RADS scoring system for multiparametric MRI of the prostate with targeted MR/TRUS fusion-guided biopsy at 3.0 Tesla. Eur Radiol 24, 344–352 (2014).

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  • ESUR score
  • MR/TRUS fusion-guided biopsy
  • Multiparametric MRI
  • Prostate cancer