PI-RADS · Próstata

PI-RADS Prostate Imaging Reporting and Data System v2.1

vigente

Assessment of clinically significant prostate cancer likelihood on multiparametric MRI, with the dominant sequence depending on zone.

Índice de referência, não é suporte à decisão clínica. O RadCommons apresenta conteúdo de referência reescrito a partir de critérios publicados e com link para a fonte primária. Confira sempre a publicação primária vigente. Não é um dispositivo médico nem substitui o julgamento clínico. O radiologista responsável pelo laudo permanece o autor e o responsável.

Escala de categorias

1 2 3 4 5

As figuras e tabelas estão na fonte primária. Abrir a fonte. O RadCommons reescreve e cita, não reproduz figuras protegidas por direitos autorais.

Procedência e vigência

Órgão emissor: ACR, ESUR, AdMeTech
Versão: v2.1
Ano: 2019
Família: léxico
Tipo de lógica: matrix
Modalidade: MRI
Fonte primária: Prostate Imaging Reporting and Data System Version 2.1: 2019 Update of Prostate Imaging Reporting and Data System Version 2 · doi:10.1016/j.eururo.2019.02.033
Última verificação: 2026-06-22
Última checagem: 2026-06-22

Lógica de decisão

Forma estruturada (matrix). Uma futura calculadora a lê; as categorias abaixo são a superfície legível.

Zone dependent dominant sequence rules and the DCE upgrade rule pending sourcing with locator.

Mostrar a lógica estruturada (JSON)

{
  "axes": {
    "zone": [
      "peripheral",
      "transition"
    ],
    "dominant_sequence": [
      "DWI",
      "T2"
    ],
    "dce": [
      "positive",
      "negative"
    ]
  },
  "categories": [
    "1",
    "2",
    "3",
    "4",
    "5"
  ],
  "cells": null
}

Categorias num relance

Cat.	Significado	Conduta	Risco	Fonte
1	Very low likelihood of clinically significant cancer Overall assessment category meaning is 'very low' likelihood. In the peripheral zone (PZ), DWI/ADC is the dominant (primary determining) sequence, and a category 1 corresponds to no abnormality visible on the ADC map or on high b-value DWI. In the transition zone (TZ), T2-weighted imaging is dominant, and a category 1 is a normal-appearing TZ (rare) or a round, completely encapsulated 'typical' nodule.	—	Clinically significant prostate cancer is highly unlikely (very low likelihood).	okfonte radiologyassistant.nl PI-RADS v2.1 page, Peripheral zone DWI/ADC category 1 and Transition zone T2W category 1 descriptions; assessment category meaning section
2	Low Overall meaning is 'low' likelihood. In the PZ (DWI dominant), category 2 is linear/wedge-shaped hypointensity on ADC and/or linear/wedge-shaped hyperintensity on high b-value DWI. In the TZ (T2 dominant), category 2 is a mostly encapsulated nodule or a homogeneous circumscribed nodule without encapsulation; a TZ T2W score of 2 remains PI-RADS 2 when the DWI/ADC score is 3 or less.	—	Clinically significant prostate cancer is unlikely (low likelihood).	okfonte radiologyassistant.nl PI-RADS v2.1 page, Peripheral zone DWI/ADC category 2 and Transition zone T2W category 2 descriptions plus the TZ T2-with-DWI adjustment note
3	Intermediate, equivocal Overall meaning is 'intermediate' (equivocal/indeterminate). In the PZ (DWI dominant), category 3 is focal hypointensity on ADC that is discrete and different from background and/or focal hyperintensity on high b-value DWI. The dynamic contrast-enhanced (DCE) upgrade rule applies here: a PZ DWI/ADC category 3 lesion stays PI-RADS 3 if DCE enhancement is negative (no focal enhancement) but is upgraded to PI-RADS 4 if DCE shows focal (positive) enhancement. In the TZ (T2 dominant), category 3 is heterogeneous signal intensity with obscured margins; a TZ T2W score of 3 remains PI-RADS 3 when the DWI/ADC score is less than 5.	—	Presence of clinically significant prostate cancer is equivocal (intermediate likelihood).	okfonte radiologyassistant.nl PI-RADS v2.1 page, Peripheral zone DWI/ADC category 3 description (including the DCE rule '...remains PI-RADS score 3 if there is no focal enhancement, but becomes PI-RADS score 4 if the enhancement is focal') and Transition zone T2W category 3 plus adjustment note
4	High Overall meaning is 'high' likelihood. In the PZ (DWI dominant), category 4 is focal markedly hypointense ADC with markedly hyperintense high b-value DWI, measuring less than 1.5 cm in greatest dimension. A PZ DWI category 3 lesion is also assigned PI-RADS 4 when DCE enhancement is positive (focal). In the TZ (T2 dominant), category 4 is a lenticular or non-circumscribed, homogeneous, moderately hypointense focus less than 1.5 cm in greatest dimension.	—	Clinically significant prostate cancer is likely (high likelihood).	okfonte radiologyassistant.nl PI-RADS v2.1 page, Peripheral zone DWI/ADC category 4 and Transition zone T2W category 4 descriptions
5	Very high Overall meaning is 'very high' likelihood. In the PZ (DWI dominant) and TZ (T2 dominant), category 5 has the same features as category 4 but measures 1.5 cm or greater in greatest dimension, or shows definite extraprostatic extension (EPE) or invasive behavior.	—	Clinically significant prostate cancer is highly likely (very high likelihood).	okfonte radiologyassistant.nl PI-RADS v2.1 page, Peripheral zone DWI/ADC category 5 and Transition zone T2W category 5 descriptions

Referências cruzadas

fronteira compartilhadaBI-RADS. Breast Imaging Reporting and Data System, 5th editionShares the Reporting and Data System framework that BI-RADS established.

Histórico de versões

Data	Evento	Detalhe	Situação
2019-03-01	revised	PI-RADS v2.1 published, updating v2 (2015). evidência	confirmado

Quickstart da APIGET /api/v1/systems/pi-rads-v2-1aberto

curl -s "https://radcommons.laudos.ai/api/v1/systems/pi-rads-v2-1"

Ver documentação completa →