Editing Prostate Cancer: Diagnosis and evaluation (section)

====== <span style="color:#ff0000">Prostate Imaging and Reporting Archiving Data System (PI-RADS) ======
* '''Provides guidance for interpretation of different sequences and prostate zones'''
*Introduced in 2012, revised in 2015 (version 2.0)
*'''Each lesion is scored, using a 5-point scale based on the likelihood (probability) that mpMRI findings correlate with the presence of a clinically significant cancer'''
**Clinically significant cancer is defined on pathology/histology as (3):[https://pubmed.ncbi.nlm.nih.gov/26427566/]
**#Gleason score ≥7 (including 3+4 with prominent but not predominant Gleason 4 component) and/or 
**#Volume ≥0.5cc and/or 
**#Extra prostatic extension(EPE).
**'''Detection rates by PI-RADS score for any prostate cancer[https://pubmed.ncbi.nlm.nih.gov/37096582/]'''
*** '''PR 1-2: 15%'''
*** '''PR 3: 25%'''
*** '''PR 4: 58%'''
*** '''PR 5: 85%'''
**'''<span style="color:#ff0000">Positive predictive values for ISUP grade group ≥2 based on PI-RADS score:</span>[https://pubmed.ncbi.nlm.nih.gov/35393568/]'''
***'''<span style="color:#ff0000">PI-RADS 1-2: 7%[https://pubmed.ncbi.nlm.nih.gov/37096582/]</span>'''
***'''<span style="color:#ff0000">PI-RADS 3: 12–15%</span>'''
***'''<span style="color:#ff0000">PI-RADS 4: 39–48%</span>'''
***'''<span style="color:#ff0000">PI-RADS 5: 72%</span>'''
**If PIRADS[https://pubmed.ncbi.nlm.nih.gov/26427566/]
***≥4 or 5, biopsy should be considered
***≤3, biopsy may or may not be appropriate, depending on factors other than mpMRI alone
* Lesions in the peripheral zone appear round or irregular, and are focally hypointense, whereas transition zone lesions are non-circumscribed and moderately hypointense, and may exhibit a characteristic ‘‘erased charcoal’’ sign.