CC BY-NC-ND 4.0 · Journal of Gastrointestinal and Abdominal Radiology 2019; 02(01): 004-017
DOI: 10.1055/s-0039-1683454
Review Article
Indian Society of Gastrointestinal and Abdominal Radiology

Multiparametric MRI Approach to Prostate Cancer with a Pictorial Essay on PI-RADS

Palak B. Popat
1  Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, Maharashtra, India
,
Sharad Maheshwari
2  Department of Radiodiagnosis, Kokilaben Dhirubhai Ambani Hospital, Andheri, Mumbai, Maharashtra, India
,
Nilesh P. Sable
1  Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, Maharashtra, India
,
Meenakshi Thakur
1  Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, Maharashtra, India
,
Aparna Katdare
1  Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, Maharashtra, India
› Author Affiliations
Funding None.
Further Information

Publication History

Received: 13 November 2018

Accepted after revision: 02 December 2018

Publication Date:
24 June 2019 (online)

  

Abstract

The biology of prostate cancer is indolent, and incidence does not reflect mortality. This has led to reframed screening guidelines pivoting around serum prostate-specific antigen (PSA) and conceptualizing clinically significant prostate cancer (CSC), triaging active surveillance and intervention. A resultant paradigm shift in magnetic resonance imaging (MRI) from diagnosing cancer to focusing on detecting CSC led to the establishment of PI-RADS v2 (prostate imaging reporting and data systems, version 2). In this article, we present an approach to analyzing suspicious prostate lesions on multiparametric MRI (mp-MRI) and assigning them a PI-RADS assessment score based on the current version 2 for standardized reporting, strengthening diagnostic accuracy, and improving clinical acceptance. We also present pitfalls and challenges that a radiologist should be aware of, for increasing diagnostic accuracy.