PI-RADS® 2.1

Prostate Imaging Reporting & Data System
A joint effort by ACR, AdMeTech Foundation and ESUR.

PI-RADS 2.1 Calculator
Do you have an adequate DWI?
Do you have an adequate DCE?
Where is the lesion located?

Cannot calculate the PI-RADS score:
If both DWI and DCE are inadequate or absent, assessment should be limited to staging for determination of extraprostatic extension.
How does the lesion look on DCE?
How does the lesion look on DWI and ADC?
How does the lesion look on T2w imaging?
How does the lesion look on T2w imaging?

→ Clinically significant cancer is highly unlikely to be present.
→ Clinically significant cancer is highly unlikely to be present.
→ Clinically significant cancer is highly unlikely to be present.
→ Clinically significant cancer is unlikely to be present.
→ Clinically significant cancer is unlikely to be present.
→ Clinically significant cancer is unlikely to be present.
→ Clinically significant cancer is unlikely to be present.
→ The presence of clinically significant cancer is equivocal.
→ The presence of clinically significant cancer is equivocal.
→ The presence of clinically significant cancer is equivocal.
→ The presence of clinically significant cancer is equivocal.
→ The presence of clinically significant cancer is equivocal.
→ Clinically significant cancer is likely to be present.
→ Clinically significant cancer is likely to be present.
→ Clinically significant cancer is likely to be present.
→ Clinically significant cancer is likely to be present.
→ Clinically significant cancer is highly likely to be present.
→ Clinically significant cancer is highly likely to be present.
→ Clinically significant cancer is highly likely to be present.
→ Clinically significant cancer is likely to be present.
→ Clinically significant cancer is likely to be present.
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Lesion-level chance of malignancy per PI‐RADS® v2.1 score, according to Oerther et al. ²:

  • PI-RADS 1 – Very low (~2%)
  • PI-RADS 2 – Low (~4%)
  • PI-RADS 3 – Intermediate (~20%)
  • PI-RADS 4 – High (~52%)
  • PI-RADS 5 – Very high (~89%)

All images on this page are obtained from ACR's PI-RADS atlas.

Click here to download the full document for PI-RADS 2.1 from ACR's website.

Reference:
  1. Turkbey B, Rosenkrantz AB, Haider MA, 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):340-351. doi:10.1016/j.eururo.2019.02.033
  2. Oerther B, Engel H, Bamberg F, Sigle A, Gratzke C, Benndorf M. Cancer detection rates of the PI-RADSv2.1 assessment categories: systematic review and meta-analysis on lesion level and patient level. Prostate Cancer Prostatic Dis. 2022;25(2):256-263. doi:10.1038/s41391-021-00417-1

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