GuidelineACR / ESUR / AdMeTechmpMRIProstate Structured report

PI-RADS

ACR / ESUR / AdMeTech · v2.1 · Updated v2.1 (2019)

Detection and risk stratification of clinically significant prostate cancer on multiparametric MRI. T2W, DWI, and DCE assessment by zone.

Applies to

Detection of clinically significant prostate cancer in treatment-naïve patients · Multiparametric prostate MRI at 1.5 T or 3 T

Does NOT apply to

Post-treatment surveillance (use PI-RR) · Recurrent disease

Modality

mpMRI

Evidence

Multi-society consensus

30-second summary

Assign a 1–5 score per lesion by dominant sequence: DWI in the peripheral zone, T2W in the transition zone. Score 4/5 warrants targeted biopsy.

Overview

Detection and risk stratification of clinically significant prostate cancer on multiparametric MRI. T2W, DWI, and DCE assessment by zone.

Score — action

Score	Action
PI-RADS 1–2	Clinically significant cancer unlikely — routine follow-up
PI-RADS 3	Equivocal — clinical decision (biopsy, PSA density, follow-up MRI)
PI-RADS 4	Likely cancer — targeted biopsy
PI-RADS 5	Highly likely cancer — targeted biopsy, staging