Limitation
PI-RADSv2.1 was observed to be very effective for detecting lesions, for determining patient selection for biopsy, identifying risk level for patients with prostate cancer suspicion, and follow-up strategies according to risk level. When the PI-RADS≥3 cut-off value is increased to PI-RADS≥4, the significant increase in the specificity, PPV and interobserver agreement suggests that the PI-RADS3 criteria will be revised in new versions of the PI-RADS.
When lesions with DCE positivity and DWI score 3 upgrading PI-RADS 3 to 4 and PI-RADS 4 lesions with DWI score 4 are compared, we identified significant differences between ISUP grades. For this reason, we suggest there should be differences in the scoring of these groups.
PI-RADSv2.1 is created to increase interobserver agreement within the framework of v2 and also provides additional explanations for certain criteria. We believe that, as more data to be obtained with further studies, PI-RADS guidelines will be more accurate.