PI-RADS (Prostate Imaging Reporting and Data System) is the standard for assessing prostate multiparametric MRI, assigning each lesion a category from 1 (clinically significant cancer highly unlikely) to 5 (highly likely).

How does zone affect scoring?

In the peripheral zone, DWI is the dominant sequence and DCE resolves a DWI score of 3. In the transition zone, T2W is dominant: a T2W score of 2 is upgraded to PI-RADS 3 when DWI is ≥4, and a T2W score of 3 is upgraded to PI-RADS 4 when DWI is 5.

Is this a medical device?

No. It is for educational and research purposes only, is not a regulatory-cleared medical device, and does not replace professional medical judgment.

Aperivue RADS

Prostate mpMRI Report Generator

Structured reporting with PI-RADS v2.1 · Zone-aware · Multi-lesion · PACS-ready output

Calculator inputs are in English. Complete the fields below to generate a PACS-ready report.

Indication

PSA (ng/mL)

Prostate volume (mL)

Comparison

Lesion Assessment

Lesions

Label

Size (mm)

Side

Level

Zone

Select a zone — DWI is the dominant sequence in the peripheral zone, T2W in the transition zone.

Extraprostatic extension (EPE) — used for index-lesion tie-break

Sequence Scores (1–5)

T2W

DWI

DCE

DCE only changes the category for a peripheral-zone DWI score of 3 (positive → 4, negative → 3).

Select a zone to begin.

Auto-generated from lesions

MULTIPARAMETRIC MRI OF THE PROSTATE — PI-RADS v2.1

TECHNIQUE: Multiparametric MRI (T2-weighted, diffusion-weighted, and dynamic contrast-enhanced imaging).
COMPARISON: None available.

FINDINGS:

Prostate lesions:
1. Lesion 1 (Not specified not specified):
   Incomplete input — select zone and the dominant-sequence score to categorize.

IMPRESSION:
No categorizable lesion. Complete the dominant-sequence scores to assign PI-RADS.

PI-RADS v2.1 — assessment categories

Likelihood of clinically significant prostate cancer by PI-RADS v2.1 category, mirroring the calculator.

Category	Likelihood of clinically significant cancer	Clinical note
PI-RADS 1	Clinically significant cancer is highly unlikely.	PI-RADS is a risk category; manage per clinical risk factors and local protocol.
PI-RADS 2	Clinically significant cancer is unlikely.	PI-RADS is a risk category; manage per clinical risk factors and local protocol.
PI-RADS 3	The presence of clinically significant cancer is equivocal (intermediate).	Equivocal; correlate with PSA density and clinical risk factors per local protocol.
PI-RADS 4	Clinically significant cancer is likely.	Correlate with PSA density and clinical risk factors; targeted biopsy may be considered per local protocol.
PI-RADS 5	Clinically significant cancer is highly likely.	Correlate with PSA density and clinical risk factors; targeted biopsy may be considered per local protocol.

Key decision rules (v2.1)

PI-RADS v2.1 is zone-aware: DWI is the dominant sequence in the peripheral zone (PZ) and T2W is the dominant sequence in the transition zone (TZ).
In the PZ, the DWI score sets the category directly, except for DWI 3 which DCE resolves: a positive DCE upgrades DWI 3 to PI-RADS 4.
When DCE is negative, unavailable, or inadequate, a PZ DWI 3 stays PI-RADS 3 (the DWI category is final).
In the TZ, the T2W score sets the category; a T2W 2 with DWI ≥4 is upgraded to PI-RADS 3, and a T2W 3 with DWI 5 is upgraded to PI-RADS 4.
PI-RADS is a risk category, not a management prescription; biopsy decisions are made clinically per risk factors and local protocol.