Abstract
Multiparametric prostate MRI integrates both anatomical sequences and functional imaging, and it has undergone rapid growth in the last decade. At least in part, the increased adoption of MRI is due to the development of the PI-RADS scoring system, which improved the standardization of acquisition and interpretation of prostate MRI. Further, accumulated experience with PI-RADS has shown good accuracy in prostate cancer detection. The latest revision of PI-RADS addressed a few shortcomings of earlier versions. Herein we present a practical approach to the use of PI-RADS to detect prostate cancer, as well as to avoid pitfalls that mimic malignancy.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Oberlin DT, Casalino DD, Miller FH, Meeks JJ. Dramatic increase in the utilization of multiparametric magnetic resonance imaging for detection and management of prostate cancer. Abdom Radiol. 2017;42(4):1255–8.
Barentsz JO, Richenberg J, Clements R, Choyke P, Verma S, Villeirs G, et al. ESUR prostate MR guidelines 2012. Eur Radiol. 2012;22(4):746–57.
Westphalen AC, Rosenkrantz AB. Prostate imaging reporting and data system (PI-RADS): reflections on early experience with a standardized interpretation scheme for multiparametric prostate MRI. AJR Am J Roentgenol. 2014;202(1):121–3.
Weinreb JC, Barentsz JO, Choyke PL, Cornud F, Haider MA, Macura KJ, et al. PI-RADS prostate imaging reporting and data system: 2015, version 2. Eur Urol. 2016;69(1):16–40.
Turkbey B, Rosenkrantz AB, Haider MA, Padhani AR, Villeirs G, Macura KJ, 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(3):340–51.
Vache T, Bratan F, Mege-Lechevallier F, Roche S, Rabilloud M, Rouviere O. Characterization of prostate lesions as benign or malignant at multiparametric MR imaging: comparison of three scoring systems in patients treated with radical prostatectomy. Radiology. 2014;272(2):446–55.
Akin O, Sala E, Moskowitz CS, Kuroiwa K, Ishill NM, Pucar D, et al. Transition zone prostate cancers: features, detection, localization, and staging at endorectal MR imaging. Radiology. 2006;239(3):784–92.
Hoeks CM, Hambrock T, Yakar D, Hulsbergen-van de Kaa CA, Feuth T, Witjes JA, et al. Transition zone prostate cancer: detection and localization with 3-T multiparametric MR imaging. Radiology. 2013;266(1):207–17.
Rosenkrantz AB, Kim S, Lim RP, Hindman N, Deng FM, Babb JS, et al. Prostate cancer localization using multiparametric MR imaging: comparison of prostate imaging reporting and data system (PI-RADS) and Likert scales. Radiology. 2013;269(2):482–92.
Greer MD, Shih JH, Lay N, Barrett T, Kayat Bittencourt L, Borofsky S, et al. Validation of the dominant sequence paradigm and role of dynamic contrast-enhanced imaging in PI-RADS version 2. Radiology. 2017;285(3):859–69.
ACR® American College of Radiology. PI-RADS® Prostate Imaging-Reporting and Data System. 2019 V 2.1. https://www.acr.org/-/media/ACR/Files/RADS/Pi-RADS/PIRADS-V2-1.pdf?la=en
Jordan EJ, Fiske C, Zagoria RJ, Westphalen AC. Evaluating the performance of PI-RADS v2 in the non-academic setting. Abdom Radiol. 2017;42(11):2725–31.
Padhani AR, Liu G, Koh DM, Chenevert TL, Thoeny HC, Takahara T, et al. Diffusion-weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations. Neoplasia. 2009;11(2):102–25.
Westphalen AC, Fazel F, Nguyen H, Cabarrus M, Hanley-Knutson K, Shinohara K, et al. Detection of clinically signifi cant prostate cancer with PIRADS v2 scores, PSA density, and ADC values in regions with and without mpMRI visible lesions. Int Braz J Urol. 2019;45:713–23.
Jordan EJ, Fiske C, Zagoria R, Westphalen AC. PI-RADS v2 and ADC values: is there room for improvement? Abdom Radiol. 2018;43(11):3109–16.
Turkbey B, Shah VP, Pang Y, Bernardo M, Xu S, Kruecker J, et al. Is apparent diffusion coefficient associated with clinical risk scores for prostate cancers that are visible on 3-T MR images? Radiology. 2011;258(2):488–95.
Donati OF, Mazaheri Y, Afaq A, Vargas HA, Zheng J, Moskowitz CS, et al. Prostate cancer aggressiveness: assessment with whole-lesion histogram analysis of the apparent diffusion coefficient. Radiology. 2014;271(1):143–52.
Rosenkrantz AB, Taneja SS. Radiologist, be aware: ten pitfalls that confound the interpretation of multiparametric prostate MRI. AJR Am J Roentgenol. 2014;202(1):109–20.
Rosenkrantz AB, Babb JS, Taneja SS, Ream JM. Proposed adjustments to PI-RADS version 2 decision rules: impact on prostate Cancer detection. Radiology. 2017;283(1):119–29.
Muglia VF, Westphalen AC, Wang ZJ, Kurhanewicz J, Carroll PR, Coakley FV. Endorectal MRI of prostate cancer: incremental prognostic importance of gross locally advanced disease. AJR Am J Roentgenol. 2011;197(6):1369–74.
Vargas HA, Akin O, Franiel T, Goldman DA, Udo K, Touijer KA, et al. Normal central zone of the prostate and central zone involvement by prostate cancer: clinical and MR imaging implications. Radiology. 2012;262(3):894–902.
Woo S, Suh CH, Kim SY, Cho JY, Kim SH. Diagnostic performance of prostate imaging reporting and data system version 2 for detection of prostate Cancer: a systematic review and diagnostic meta-analysis. Eur Urol. 2017;72(2):177–88.
Venderink W, van Luijtelaar A, Bomers JG, van der Leest M, Hulsbergen-van de Kaa C, Barentsz JO, et al. Results of targeted biopsy in men with magnetic resonance imaging lesions classified equivocal, likely or highly likely to be clinically significant prostate cancer. Eur Urol. 2017;73:353–60.
Mehralivand S, Bednarova S, Shih JH, Mertan FV, Gaur S, Merino MJ, et al. Prospective evaluation of PI-RADS version 2 using the International Society of Urological Pathology Prostate Cancer Grade Group System. J Urol. 2017;198(3):583–90.
Barkovich EJ, Shankar PR, Westphalen AC. A systematic review of the existing prostate imaging reporting and data system version 2 (PI-RADSv2) literature and subset meta-analysis of PI-RADSv2 categories stratified by Gleason scores. AJR Am J Roentgenol. 2019;212(4):847–54.
Rosenkrantz AB, Ginocchio LA, Cornfeld D, Froemming AT, Gupta RT, Turkbey B, et al. Interobserver reproducibility of the PI-RADS version 2 lexicon: a multicenter study of six experienced prostate radiologists. Radiology. 2016;280(3):793–804.
Lin WC, Muglia VF, Silva GE, Chodraui Filho S, Reis RB, Westphalen AC. Multiparametric MRI of the prostate: diagnostic performance and interreader agreement of two scoring systems. Br J Radiol. 2016;89(1062):20151056.
Greer MD, Shih JH, Lay N, Barrett T, Bittencourt L, Borofsky S, et al. Interreader variability of prostate imaging reporting and data system version 2 in detecting and assessing prostate Cancer lesions at prostate MRI. AJR Am J Roentgenol. 2019;212:1197–205. 10.2214/AJR.18.20536.
Tran GN, Leapman MS, Nguyen HG, Cowan JE, Shinohara K, Westphalen AC, et al. Magnetic resonance imaging-ultrasound fusion biopsy during prostate cancer active surveillance. Eur Urol. 2017;72(2):275–81.
Borofsky S, George AK, Gaur S, Bernardo M, Greer MD, Mertan FV, et al. What are we missing? False-negative cancers at multiparametric MR imaging of the prostate. Radiology. 2018;286(1):186–95.
Garcia-Reyes K, Nguyen HG, Zagoria RJ, Shinohara K, Carroll PR, Behr SC, et al. Impact of lesion visibility on Transrectal ultrasound on the prediction of clinically significant prostate cancer (Gleason score 3 + 4 or greater) with transrectal ultrasound-magnetic resonance imaging fusion biopsy. J Urol. 2018;199(3):699–705.
Meermeier NP, Foster BR, Liu JJ, Amling CL, Coakley FV. Impact of direct MRI-guided biopsy of the prostate on clinical management. AJR Am J Roentgenol. 2019;213(2):371–6.
Rosenkrantz AB, Verma S, Choyke P, Eberhardt SC, Eggener SE, Gaitonde K, et al. Prostate magnetic resonance imaging and magnetic resonance imaging targeted biopsy in patients with a prior negative biopsy: a consensus statement by AUA and SAR. J Urol. 2016;196(6):1613–8.
Sanda MG, Chen RC, Crispino T, Freedland S, Greene K, Klotz LH, Makarov DV, Nelson JB, Reston J, Rodrigues G, Sandler HM, Taplin ME, Cadeddu JA. Clinically localized prostate cancer: AUA/ASTRO/SUO Guideline 2017. Available from: https://www.auanet.org/guidelines/prostate-cancer-clinically-localized-guideline
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Foster, B.R., Westphalen, A.C. (2020). Interpretation of Multiparametric MRI Using PI-RADS (Prostate Imaging-Reporting and Data System). In: Tirkes, T. (eds) Prostate MRI Essentials. Springer, Cham. https://doi.org/10.1007/978-3-030-45935-2_7
Download citation
DOI: https://doi.org/10.1007/978-3-030-45935-2_7
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-45934-5
Online ISBN: 978-3-030-45935-2
eBook Packages: MedicineMedicine (R0)