ECR 2024 PI-RADS Update - What is next?

Learning Objectives
1. To give an update on the performance characteristics of PI-RADS v2.1
2. To learn the limitations of the v2.1 system and the barriers to issuing updates and reversions
3. To inform on developments that impact the performance of the MRI-diagnosis pathway including image quality, expanded patient selections, optimization of benefits-harm, and deep learning impacts
Key messages:
1. PI-RADS v2.1 is performing as expected; higher prevalence of csPCa with increasing clinical suspicion and a step-function
2. Limitations: persistent highly variable false positive rate & apparently higher prevalence of PI-RADS 3
3. Missing clinical utilities related to the benefits and harm of different MRI biopsy pathways
4. Diagnostic criteria changes are constrained by ACR because clinical pathway impacts need assessing
5. Emerging multistep, quality assured risk stratified MRI pathway incorporating patient preferences
6. Focus: Focus: QA/QC of pathway effectiveness, impacts on biopsy strategies, integration into nomograms, AI in workflow, new indications (screening & AS)

[@dimalitvinovich]

Thanks for this unique information. I am looking forward the new version of PI-QUAL system, because it is really help me to say urologist about their patient's mri quality. I am agree with your idea about US certification and accreditation, it is really help everybody to improve the quality of mri and reports. It is sound sad, but i can trust only a few center of MRi in Russia, who make high quality multiparametric MRI. And another hospitals can do what they can (pi-qual 2-3) and use PI-RADS2.1 for their reports. It is the main idea why i can not work with different hospital in my country. But you should know that we follow your advices, thanks again.