PI-RAD v2 Assessment CategoriesPI-RADS 1 – Very low (clinically significant cancer is highly unlikely to be present)

PI-RADS 2 – Low (clinically significant cancer is unlikely to be present)

PI-RADS 3 – Intermediate (the presence of clinically significant cancer is equivocal)

PI-RADS 4 – High (clinically significant cancer is likely present)

PI-RADS 5 – Very high (clinically significant cancer is highly likely to be present)

MRI OF THE PROSTATE

Scoring

Scoring

Extra-Prostatic Extension

• Asymmetry, thickening, or irregularity of the neurovascular bundles

• Bulge of the prostatic capsule• Irregular or spiculated margins• Obliteration of the rectoprostatic

angle• Tumor-capsule interface >1 cm• Capsular breach with measurable

extraprostatic disease• Bladder wall invasion

Seminal Vesicle Invasion

• Focal or diffuse T2 hypointensity within the seminal vesicle

• Loss of the normal angle between the base of the prostate and the seminal vesicle

• Direct tumor extension into and surrounding the seminal vesicle

False Positives● Benign Prostatic

Hyperplasia (BPH)

● Hemorrhage

● Cysts

● Calcification

● Prostatitis

● Atrophy

● Fibrosis